Individual
IREATHA LASHONDA WARDSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1133 EAST LASKE ROAD, ERIE, PA 16507
(814) 451-0824
Mailing address
1133 EAST LASKE ROAD, ERIE, PA 16507
(814) 451-0824
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN591212
PA
Other
Enumeration date
04/27/2010
Last updated
04/27/2010
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