Basic Information
| Provider Information | |||||||||
| NPI: | 1346714854 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUSFELD | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | WAYNE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | II | ||||||||
| Credential: | DNP, CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5723 ASHFORD RIDGE LN | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774505634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8326575588 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3702 AUTOMATION WAY | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805255737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702242985 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2019 | ||||||||
| LastUpdateDate: | 01/25/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 830349 | TX | N | Nursing Service Providers | Registered Nurse | 367500000X | C-APN.0001374-C-CRNA | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.