Provider Demographics
NPI:1659788719
Name:HYPNOS LLC
Entity Type:Organization
Organization Name:HYPNOS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:BROCKFORD
Authorized Official - Last Name:DUREL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:443-528-4353
Mailing Address - Street 1:107 FORDING BND
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-5161
Mailing Address - Country:US
Mailing Address - Phone:443-528-4353
Mailing Address - Fax:
Practice Address - Street 1:107 FORDING BND
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5161
Practice Address - Country:US
Practice Address - Phone:443-528-4353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty