Individual
PATRICIA MORTENSEN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-2104
(860) 679-2000
Mailing address
99 EAST RIVER DRIVE, 5TH FLOOR, EAST HARTFORD, CT 06108
(860) 282-0833
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1114911
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042162
AANA CERT. NUMBER
MN
Enumeration date
05/11/2006
Last updated
04/16/2021
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