Provider Demographics
NPI:1760620785
Name:HOTTINGER, NATALIE D (CRNA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:D
Last Name:HOTTINGER
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 1:800 N FANT ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5708
Mailing Address - Country:US
Mailing Address - Phone:864-512-1417
Mailing Address - Fax:864-512-1823
Practice Address - Street 1:800 N FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5708
Practice Address - Country:US
Practice Address - Phone:864-512-1340
Practice Address - Fax:864-512-1749
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2423367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000940321AMedicaid
GA000940321BMedicaid
SCAN0504Medicaid
GA000940321AMedicaid
SCQ291125965Medicare PIN