Individual
CAROL ANN WILKENING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1611 GLADYS AVE, GRAND HAVEN, MI 49417
(616) 402-4855
Mailing address
1611 GLADYS AVE, GRAND HAVEN, MI 49417
(616) 402-4855
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704119259
MI
Other
Enumeration date
06/23/2006
Last updated
07/08/2007
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