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STEPHANIE POLING WISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
20 MEDICAL VILLAGE DR, SUITE 258, EDGEWOOD, KY 41017-5401
(859) 301-2211
Mailing address
20 MEDICAL VILLAGE DR, SUITE 258, EDGEWOOD, KY 41017-5401

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3009532
KY

Other

Enumeration date
03/11/2015
Last updated
07/15/2015
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