Individual
JOHN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4351 E LOHMAN AVE, LAS CRUCES, NM 88011-8259
(970) 216-5385
Mailing address
PO BOX 436, OURAY, CO 81427-0436
(970) 216-5385
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
10406-33
WI
367500000X
Certified Registered Nurse Anesthetist
209021371
IL
367500000X
Certified Registered Nurse Anesthetist
2355
MN
367500000X
Certified Registered Nurse Anesthetist
AP61248892
WA
367500000X
Certified Registered Nurse Anesthetist
APN.0996269-CRNA
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA 01415
NM
Other
Enumeration date
02/18/2016
Last updated
05/11/2022
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