Individual
MICHAEL A WIENCEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 WESTWOOD DR, HAMILTON, MT 59840-2345
(406) 363-2211
(406) 375-4590
Mailing address
1200 WESTWOOD DR, HAMILTON, MT 59840-2345
(406) 363-2211
(406) 375-4846
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN15583
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770520769
—
ID
05
—
1770520769
—
MT
05
—
1770520769
—
WA
Enumeration date
05/31/2006
Last updated
11/05/2015
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