Provider Demographics
NPI:1780621680
Name:HOHENBERGER, LINDA F (CRNA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:F
Last Name:HOHENBERGER
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 1:1180 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3190
Mailing Address - Country:US
Mailing Address - Phone:734-243-5300
Mailing Address - Fax:734-243-9956
Practice Address - Street 1:5085 MONROE ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3455
Practice Address - Country:US
Practice Address - Phone:419-776-4000
Practice Address - Fax:419-776-1032
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704093833367500000X
OH01265367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4317272Medicaid
MIN14190005Medicare PIN
MI0M91310010Medicare ID - Type Unspecified
MI4317272Medicaid
OHHO8241862Medicare PIN