Basic Information
| Provider Information | |||||||||
| NPI: | 1932452182 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERINGHAUS | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8000 E MAPLEWOOD AVE | ||||||||
| Address2: | STE 200 | ||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801114727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196907653 | ||||||||
| FaxNumber: | 4196977726 | ||||||||
| Practice Location | |||||||||
| Address1: | 2801 BAY PARK DR | ||||||||
| Address2: | |||||||||
| City: | OREGON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436164920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196907653 | ||||||||
| FaxNumber: | 4196977726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2012 | ||||||||
| LastUpdateDate: | 07/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | APRN.CRNA.13990 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | APN.0991732-CRNA | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.