Provider Demographics
NPI:1083763171
Name:HITCHENS AND HENKE, PA
Entity Type:Organization
Organization Name:HITCHENS AND HENKE, PA
Other - Org Name:WATCHFUL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HITCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:410-692-6601
Mailing Address - Street 1:1715 FARMSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:JARRETTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21084-1507
Mailing Address - Country:US
Mailing Address - Phone:410-692-6601
Mailing Address - Fax:410-692-9566
Practice Address - Street 1:1715 FARMSHIRE CT
Practice Address - Street 2:
Practice Address - City:JARRETTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21084-1507
Practice Address - Country:US
Practice Address - Phone:410-692-6601
Practice Address - Fax:410-692-9566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF737OtherFEDERAL BCBS
MDK884WAOtherCAREFIRST BLUE CROSS BLUE
MD299291400Medicaid
MDK884WAOtherCAREFIRST BLUE CROSS BLUE