Individual
MRS. OLENA GROCE ANDERSON IV
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, MEDICAL CENTER BOULEVARD ANESTHESIA DEPARTMENT, WINSTON SALEM, NC 27157-0001
(336) 716-3069
Mailing address
2410 ATWOOD RD, WINSTON-SALEM, NC 27103-5404
(336) 716-3069
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
031353
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050210
—
NC
Enumeration date
11/18/2005
Last updated
07/08/2007
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