Individual ProviderMary Kathleen HidalgoNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907(703) 295-9360(540) 349-0514PECOS EnrollmentBased on the most recent information from CMS, provider Mary Kathleen Hidalgo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1821199159Provider TypeIndividualFull NameHidalgo, Mary KathleenCredentialCRNAGenderFemaleSole ProprietorNoEnumeration Date9/26/2006Last Updated9/23/2008Contact InformationPractice LocationPractice Address3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907Phone(703) 295-9360Fax(703) 295-9369Mailing LocationMailing Address500 Hospital Dr, Warrenton, VA 20186-3027Phone(540) 349-0514FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024167953VirginiaCode367500000XDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense1-101930AlabamaCode367500000XDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense178681Colorado