Individual
CHARLY SAMANTHA WYLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
205 MARENGO ST, FLORENCE, AL 35630-6033
(256) 768-9191
(256) 768-9775
Mailing address
PO BOX 1198, ABILENE, TX 79604-1198
(325) 670-4220
(325) 670-4040
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-113371
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1018723
TX
367500000X
Certified Registered Nurse Anesthetist
4007302
KY
Other
Enumeration date
01/22/2018
Last updated
02/19/2025
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