Individual
MRS. WENDY GEE LANGSTON KACZMAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5 MEDICAL PARK RD, COLUMBIA, SC 29203-6873
(803) 434-3294
Mailing address
1738 BANNOCKBURN DR, COLUMBIA, SC 29206-2929
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 2260
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0596
—
SC
Enumeration date
11/22/2005
Last updated
08/08/2011
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