Individual
RICHARD HUNTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 915-4624
Mailing address
W5287 NATURES WAY DRIVE DRIVE, SHERWOOD, WI 54169
(920) 915-4624
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
145985-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041904
CRNA RECERTIFICATION CARD
—
Enumeration date
12/13/2005
Last updated
12/04/2023
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