Basic Information
| Provider Information | |||||||||
| NPI: | 1790291300 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EGGEN | ||||||||
| FirstName: | HILARY | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8933 FAWN LAKE RD | ||||||||
| Address2: | |||||||||
| City: | HAZELHURST | ||||||||
| State: | WI | ||||||||
| PostalCode: | 545319504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7159771369 | ||||||||
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| Practice Location | |||||||||
| Address1: | 240 MAPLE ST | ||||||||
| Address2: | |||||||||
| City: | WOODRUFF | ||||||||
| State: | WI | ||||||||
| PostalCode: | 545689190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153568000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2017 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 9832-33 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 2154 | MN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163WG0000X | 177249-2 | MN | N | Nursing Service Providers | Registered Nurse | General Practice |
No ID Information.