MEDICARE: MISS WENDY NOLES C.R.N.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	571607	TX

General Provider Information

NPI Number	:	1164410049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS WENDY NOLES C.R.N.A.

Provider Business Mailing Address
First Line	:	10 COPPER KETTLE CT
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-4456
Country	:	US
Telephone Number	:	281-682-2295
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 COPPER KETTLE CT
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-4456
Country	:	US
Telephone Number	:	281-682-2295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	01/18/2013

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