Individual
ANDREA C WIGHTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
615 S NEW BALLAS RD DEPT OF, SAINT LOUIS, MO 63141-8221
(314) 251-6000
(636) 386-7679
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2013002899
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11031846
FL
Other
Enumeration date
01/12/2016
Last updated
05/28/2024
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