Individual
PHILIP G HESTAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-1886
(502) 587-4203
(502) 587-4155
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 587-4404
(502) 587-4156
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3000739
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000283662
BLUE SHIELD
KY
01
—
1168472
PASSPORT
KY
05
—
201071360
—
IN
01
—
2440333000
PASSPORT ADVANTAGE
KY
01
—
430079779
RAILROAD MEDICARE
—
05
—
74345620
—
KY
Enumeration date
10/04/2005
Last updated
04/05/2018
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