Provider Demographics
NPI:1033135272
Name:HOORMANN, SYLVIA G (CRNA)
Entity type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:G
Last Name:HOORMANN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1125
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-0125
Mailing Address - Country:US
Mailing Address - Phone:888-731-1036
Mailing Address - Fax:423-892-5838
Practice Address - Street 1:1 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6722
Practice Address - Country:US
Practice Address - Phone:618-463-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004029914367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO919361105Medicaid
MO203133OtherBCBS GROUP
DE1315OtherRAILROAD MEDICARE GROUP
MO203133OtherBCBS GROUP
$$$$$$$$$OtherTRICARE
$$$$$$$$$OtherTRICARE
DE1315OtherRAILROAD MEDICARE GROUP
OTH000Medicare UPIN