Individual
MRS. GWEN MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1221 WHIPPLE ST, EAU CLAIRE, WI 54703-5270
(715) 838-3311
Mailing address
2107 HEIGHTS DR, EAU CLAIRE, WI 54701-6130
(715) 834-8721
(715) 834-3087
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
132471-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000453
—
WI
Enumeration date
07/30/2008
Last updated
01/29/2009
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