Individual
SANDRA L WACHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-3406
(906) 225-3094
Mailing address
104 SURREY LN, MARQUETTE, MI 49855-9383
(906) 249-1379
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704075363
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101599640
—
MI
01
—
430024329
RAILROAD MEDICARE PIN
MI
01
—
SW075363
BLUESHIELD PIN
MI
Enumeration date
11/15/2005
Last updated
04/29/2008
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