Individual
MARY WYGANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
108 FINANCIAL PL, ELIZABETHTOWN, KY 42701-8449
(270) 737-5200
Mailing address
PO BOX 822337, PHILADELPHIA, PA 19182-2337
(866) 226-9156
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1097563
KY
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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