Healthcare Provider Details

I. General information

NPI: 1851333223
Provider Name (Legal Business Name): WENDY E. TRENERY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 S. 17TH STREET NHRMC ANESTHESIA DEPT.
WILMINGTON NC
28401-7407
US

IV. Provider business mailing address

2131 S. 17TH STREET NHRMC ANESTHESIA DEPT.
WILMINGTON NC
28401-7407
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-7128
  • Fax: 910-772-9452
Mailing address:
  • Phone: 910-343-7128
  • Fax: 910-772-9452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0200134
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: