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Individual

CAROLE B. WETHERHOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
17TH & CHEW STREET, ALLENTOWN, PA 18102
(610) 402-9099
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD, SUITE #301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN167771L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
019438
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0011679400004
PA
01
0994143
KHP CENTRAL
PA
01
1567631
HIGHMARK
PA
01
1579546
GATEWAY
PA
01
2248292000
INDEP. BLUE CROSS
PA
01
50026716
CAPITAL ADVANTAGE
PA
01
7418819
AETNA
PA
01
82872
GEISINGER
PA
01
CAQH
11267076
PA
Enumeration date
10/04/2005
Last updated
03/29/2013
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