Provider Demographics
NPI:1578524492
Name:HESS, CARLTON (CRNA)
Entity Type:Individual
Prefix:
First Name:CARLTON
Middle Name:
Last Name:HESS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4220
Mailing Address - Country:US
Mailing Address - Phone:717-217-4312
Mailing Address - Fax:717-217-4314
Practice Address - Street 1:835 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-263-0629
Practice Address - Fax:717-217-4314
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN205574L367500000X, 207L00000X
WV41453207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0068673000Medicaid
WV430064986OtherRAILROAD MEDICARE
CAQHOther11896079