Individual
MR. TIMOTHY J WAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3801 S NATIONAL, SPRINGFIELD, MO 65807
(417) 269-6000
Mailing address
1000 E PRIMROSE, STE 520, SPRINGFIELD, MO 65807
(417) 269-4550
(417) 269-4558
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
123480
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
123480
MO
Other
Enumeration date
05/03/2006
Last updated
05/04/2010
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