Provider Demographics
NPI:1710948021
Name:HAUCK, LINDA (CRNA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HAUCK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN303030L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2353011000OtherINDEPENDENCE BLUE CROSS
PA50055767OtherKEYSTONE HEALTH PLAN CENTRAL
PA1147570OtherAETNA-HMO
PA001678891OtherHIGHMARK
PA7278757OtherAETNA-NON HMO
PAP00218837OtherRR MEDICARE
PA101929OtherGEISINGER
PA50055767OtherCAPITAL BLUE CROSS
PA7278757OtherAETNA-NON HMO