Healthcare Provider Details

I. General information

NPI: 1376401893
Provider Name (Legal Business Name): FAITH WOSMEK CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 BECKER AVE SW
WILLMAR MN
56201-3302
US

IV. Provider business mailing address

6844 140TH AVE NE
SPICER MN
56288-9659
US

V. Phone/Fax

Practice location:
  • Phone: 320-235-4543
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number157206
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: