| Tyler G Higginson, CRNA | |
|
710 Riverside Dr, Waupaca, WI 54981-1941 | |
| (715) 256-3000 | |
| Not Available |
| Full Name | Tyler G Higginson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 20 Years |
| Location | 710 Riverside Dr, Waupaca, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992878789 | NPI | - | NPPES |
| 011417052 | Other | SC | DRIVERS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R79716 (South Carolina) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 3410-33 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Thedacare Medical Center-waupaca | Waupaca, WI | Hospital |
| Thedacare Regional Med Ctr - Neenah | Neenah, WI | Hospital |
| Thedacare Medical Center - New London | New london, WI | Hospital |
| Berlin Memorial Hospital | Berlin, WI | Hospital |
| Thedacare Regional Medical Center - Appleton Inc | Appleton, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Association Of Hospital Anesthesiologists Sc | 3476539875 | 81 |
| Entity Name | Thedacare Medical Center - Berlin, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760413777 PECOS PAC ID: 0446151666 Enrollment ID: O20040120000214 |
| Entity Name | Association Of Hospital Anesthesiologists Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720076474 PECOS PAC ID: 3476539875 Enrollment ID: O20050719001050 |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler G Higginson, CRNA 2109b E Capitol Dr Ste 1, Appleton, WI 54911-8726 Ph: (920) 202-3371 | Tyler G Higginson, CRNA 710 Riverside Dr, Waupaca, WI 54981-1941 Ph: (715) 256-3000 |