Individual
BEVERLY B. WYKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5 RICHLAND MEDICAL PARK, COLUMBIA, SC 29203-8000
(803) 434-2979
(803) 434-7038
Mailing address
PO BOX 1928, COLUMBIA, SC 29202-1928
(803) 454-2613
(803) 765-1732
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1916
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1236
—
SC
Enumeration date
03/22/2006
Last updated
09/20/2007
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