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Individual

DR. WESLEY KYLE MAUGHON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP, CRNA

Contact information

Practice address
1 ELLIOT WAY, MANCHESTER, NH 03103-3502
(110) 111-0117
Mailing address
PO BOX 23321, NEW YORK, NY 10087-3221

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
319065
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
088530-23
NH
367500000X
Certified Registered Nurse Anesthetist
139725
NH
367500000X
Certified Registered Nurse Anesthetist
28769
SC

Other

Enumeration date
06/28/2021
Last updated
05/28/2024
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