Individual
WILLARD WADE WISE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7822 DAVENPORT ST, OMAHA, NE 68114-3629
(402) 391-4855
(402) 391-6818
Mailing address
7822 DAVENPORT ST, OMAHA, NE 68114-3629
(402) 391-4855
(402) 391-6818
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101342
NE
Other
Enumeration date
04/22/2016
Last updated
05/23/2016
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