Individual
KEITH A WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000711
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CR000711
CRNA
SD
Enumeration date
10/08/2008
Last updated
10/08/2008
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