Individual
TANYA J. WILHELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6847 N CHESTNUT ST, RAVENNA, OH 44266-3929
(330) 297-2765
Mailing address
6847 N CHESTNUT ST, RAVENNA, OH 44266-3929
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA-01164
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720364342
—
UT
05
—
258741
—
CO
05
—
93728051
—
NM
01
—
P01083189
RR MEDICARE
NM
Enumeration date
10/27/2011
Last updated
02/02/2016
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