Individual
MEGAN WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3303
(217) 383-3265
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209024586
IL
367500000X
Certified Registered Nurse Anesthetist
305107
NC
Other
Enumeration date
12/09/2020
Last updated
05/19/2022
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