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General NPI Number Information
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NPI Number | 1174591523
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Entity Type | Individual
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Provider Name | WENDY JO PLUM CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 01/09/2018
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Provider Practice Location Address
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Address Line | 3009 S JOHN REDDITT DR # 168
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City | LUFKIN
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State | TX
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Zip | 75904-5661
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Country | US
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Telephone | 808-222-1712
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Fax |
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Provider Business Mailing Address
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Address Line | 3009 S JOHN REDDITT #168
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City | LUFKIN
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State | TX
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Zip | 75901
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Country | US
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Telephone | 808-222-1712
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN243133
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP 2721072
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License Number State | FL
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