Organization
WABASH VALLEY ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIOTT E. MCGREGORY CRNA (PRESIDENT)
(317) 218-3136
Entity
Organization
Contact information
Practice address
15788 HAZEL DELL RD, NOBLESVILLE, IN 46062-6911
(317) 218-3136
(317) 669-0439
Mailing address
PO BOX 1701, NOBLESVILLE, IN 46061-1701
(317) 218-3136
(317) 669-0439
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200242920
—
IN
Enumeration date
06/16/2006
Last updated
09/29/2015
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