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Individual

WANDA C UNTCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5000
Mailing address
300 W 27TH ST, ATTN: WILLIAM J GUTEKUNST, LUMBERTON, NC 28358-3075
(910) 671-5000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
179828
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
475
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8051675
NC
Enumeration date
07/12/2005
Last updated
04/17/2026
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