Individual
CARL EDMOND WISECAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
230 W MAIN ST STE 200, DANVILLE, KY 40422-1873
(859) 236-3726
(859) 236-3019
Mailing address
7406 LONG SHOT LN, KNOXVILLE, TN 37918-1024
(865) 315-0090
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3011958
KY
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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