Basic Information
Provider Information
NPI: 1043595523
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUESKE
FirstName: AMY
MiddleName: REBECCA
NamePrefix: MRS.
NameSuffix:  
Credential: CRNA, RN, MSN, BSN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 271647
Address2: UNC FP
City: SALT LAKE CITY
State: UT
PostalCode: 84127
CountryCode: US
TelephoneNumber: 9199665136
FaxNumber:  
Practice Location
Address1: DEPARTMENT OF ANESTHESIOLOGY
Address2: N2198 UNC HOSPITALS CB# 7010
City: CHAPEL HILL
State: NC
PostalCode: 275997010
CountryCode: US
TelephoneNumber: 9199665136
FaxNumber: 9849744873
Other Information
ProviderEnumerationDate: 10/17/2011
LastUpdateDate: 10/06/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X219544NCN Nursing Service ProvidersRegistered Nurse 
367500000X88182NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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