Eddie J Wickline in Elkhart - Nurse Anesthetist, Certified Registered
Eddie J Wickline - NPI 1891805503
Eddie J Wickline is a Nurse Anesthetist, Certified Registered in Elkhart, Indiana. Eddie J Wickline practices all healthcare services and medical treatments related to Nurse Anesthetist, Certified Registered. The NPI Number for Eddie J Wickline is 1891805503. The last update date is 2011-10-12.
Eddie J Wickline's current location address is 2310 California Rd, Elkhart, Indiana. You can contact this provider via phone number 5742640791 and fax number 5742629650. The mailing address for Eddie J Wickline is 2310 California Rd, Elkhart, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Eddie J Wickline |
|---|---|
| Address | 2310 California Rd, Elkhart, Indiana |
| Phone Number | 5742640791 |
| Fax Number | 5742629650 |
| Sole Proprietor | N |
| Credentials | CRNA |
NPI Number Detail
| NPI Number | 1891805503 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2011-10-12 |
Provider Mailing Address Detail
| Address | 2310 California Rd |
|---|---|
| City | Elkhart |
| State | Indiana (IN) |
| Post Code | 465141228 |
| Phone Number | 5742640791 |
| Fax Number | 5742629650 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Anesthetist, Certified Registered |
|---|---|
| Taxonomy | 367500000X |
| Licence No | 28137996A |
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Definition: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200295510 | IN | -- |
Post Comment/ Review Below
What is the Eddie J Wickline's 1891805503?
The Eddie J Wickline's NPI (National Provider Identifier) Number is 1891805503. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Eddie J Wickline's facilities are situated?
The facilities of Eddie J Wickline are physically located at the following address: 2310 California Rd, Elkhart, IN, 465141228.
What is Eddie J Wickline's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Eddie J Wickline's specialized field of practice is Nurse Anesthetist, Certified Registered, and the corresponding taxonomy code that categorizes this area of specialization is 367500000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1891805503 to Eddie J Wickline?
The Eddie J Wickline received its 1891805503 assignment from the Centers for Medicare & Medicaid Services on 2006-08-30.
When was the information pertaining to Eddie J Wickline most recently updated or revised?
The details related to Eddie J Wickline, including its address, specialty, and other relevant information, were last updated or revised on 2011-10-12.