Provider Demographics
NPI:1720190952
Name:HITCHCOCK, ANGELA D (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:D
Last Name:HITCHCOCK
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:PO BOX 20452
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:110 N POPLAR ST
Practice Address - Street 2:MCCULLOUGH-HYDE MEMORIAL HOSPITAL ANESTHESIA DEPT
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1204
Practice Address - Country:US
Practice Address - Phone:513-524-5574
Practice Address - Fax:513-524-5559
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN242301367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200938010OtherINDIANA MEDICAID
OH2226611Medicaid
OHP00818598OtherRR MCR
OH000000216113OtherANTHEM
OH000000216113OtherANTHEM