Individual
JENNIFER WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1000 S BECKHAM AVE, TYLER, TX 75701-1908
(903) 597-0351
Mailing address
6225 N STATE HIGHWAY 161 STE 200, IRVING, TX 75038-2241
(214) 687-0001
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
152875
TX
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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