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General NPI Number Information
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NPI Number | 1861933517
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Entity Type | Individual
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Provider Name | JOEL WADKINS RN
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Gender | Male
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 68 S SERVICE RD STE 350
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City | MELVILLE
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State | NY
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Zip | 11747-2358
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Country | US
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Telephone | 516-370-3628
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Fax |
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Provider Business Mailing Address
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Address Line | 31 CAMI WAY
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City | ELKTON
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State | MD
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Zip | 21921-7308
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Country | US
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Telephone | 410-441-0481
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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 | L6-0A00784
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License Number State | DE
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