Individual
EDNA G. WATERLANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
140 RIVER NORTH BLVD, STEPHENVILLE, TX 76401-1803
(254) 965-7020
Mailing address
PO BOX 11219, FORT WORTH, TX 76110-0219
(817) 294-7444
(817) 294-7172
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP111968
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C56U
BCBSTX
TX
Enumeration date
02/07/2006
Last updated
09/03/2025
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