Organization
RAELLE ANESTHESIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYLAN WYATT KRUSE CRNA (CEO)
(951) 335-5461
Entity
Organization
Contact information
Practice address
10694 MAGNOLIA AVE, RIVERSIDE, CA 92505-1816
(951) 335-5264
(951) 335-5471
Mailing address
10694 MAGNOLIA AVE, RIVERSIDE, CA 92505-1816
(951) 335-5264
(951) 335-5471
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
3956
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
3970
CA
367500000X
Certified Registered Nurse Anesthetist
4114
CA
Other
Enumeration date
02/14/2013
Last updated
02/23/2023
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