Individual
MRS. ALISON ROSE WALDECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4100 PARK FOREST DR STE 210, TRAVERSE CITY, MI 49684-7306
(231) 935-5770
Mailing address
1404 ASHMOOR LN, WINTERVILLE, NC 28590-9926
(616) 460-1569
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
291373
NC
163W00000X
Registered Nurse
4704299424
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704299424
MI
Other
Enumeration date
03/23/2019
Last updated
05/20/2021
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