Individual
REGENIA L. WILSON
Active
Individual
REGENIA L. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA109
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010017281
REGENCE
ID
01
—
89250
BLUE CROSS GROUP #
ID
01
—
A4092
BLUE CROSS
ID
Enumeration date
08/13/2006
Last updated
07/09/2007
Update your record
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