Individual
MR. ERIC ALLAN WRENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-5611
(864) 455-7000
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6306
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704245455
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4215
SC
367500000X
Certified Registered Nurse Anesthetist
4704245455
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AN2068
MEDICAID NBR
—
01
—
Q355564
MEDICARE NBR
—
Enumeration date
12/16/2006
Last updated
05/09/2018
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