Individual
WILLIAM KEITH WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6210 SARAH LYNNE DR, ALEXANDRIA, LA 71303-2096
(903) 677-7434
Mailing address
6210 SARAH LYNNE DR, ALEXANDRIA, LA 71303-2096
(318) 625-2133
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN054618
LA
367500000X
Certified Registered Nurse Anesthetist
AP02498
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP129728
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1439649
—
LA
05
—
3544850-02
—
TX
Enumeration date
05/01/2007
Last updated
08/23/2024
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