Individual
TARYN WIEDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(206) 662-0111
Mailing address
24 CALLISA LN, GORHAM, ME 04038-2351
(515) 577-4794
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA203065
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/31/2018
Last updated
10/06/2021
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