Wesley Pack CRNA

NPI 1467796250 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1467796250
Gender Male
Enumeration Date 11/16/2012
Last Updated 11/16/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
4370 W MAIN ST
DOTHAN AL, 36305-1056, US
Phone (334) 793-5000
Fax
Business Location
PO BOX 6907
DOTHAN AL, 36302-6907, US
Phone (334) 793-5000
Fax
Toxanomy
Taxonomy Code 367500000X
License State Alabama
License Number 1-118092
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According to our database, Wesley Pack CRNA NPI is 1467796250, taxonomy code is 367500000X and license number is 1-118092, license state is located at Alabama. Wesley Pack CRNA physically located at 4370 W Main St, Dothan AL, 36305-1056. NPI Number Wesley Pack CRNA has the Individual type.

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1467796250 NPI number is provided on an as is basis without warranty of any kind. 1467796250 is maintained by the National Plan & Provider Enumeration System. The contents of Wesley Pack CRNA are for informational purposes only.