Individual
DEVIN PONDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-5600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
16294-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100303158
—
WI
Enumeration date
12/13/2024
Last updated
02/18/2025
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