Individual
MR. RANDY RAY WIENTJES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
3042 LAKEVIEW DR, METROPOLIS, IL 62960-3119
(618) 524-9217
(618) 524-2158
Mailing address
3042 LAKEVIEW DR, METROPOLIS, IL 62960-3119
(618) 524-9217
(618) 524-2158
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209-004142
IL
367500000X
Certified Registered Nurse Anesthetist
3001002
KY
367500000X
Certified Registered Nurse Anesthetist
CR000381
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74007063
—
KY
01
—
P01099568
RAIL ROAD MEDICARE
KY
Enumeration date
07/06/2006
Last updated
09/09/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us