Individual
MRS. MARTHA GRACE WACHENHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0942
(410) 550-0443
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
253087
AZ
367500000X
Certified Registered Nurse Anesthetist
9391766
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
AC003760
MD
Other
Enumeration date
06/12/2017
Last updated
08/17/2023
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