Individual
WYATT STEWART WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
215197
NC
367500000X
Certified Registered Nurse Anesthetist
110989
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
5436
NC
Other
Enumeration date
04/20/2016
Last updated
05/13/2021
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