NPI 1417387119

Rickie Wilson, CRNA

Practitioner Certified Registered Nurse Anesthetist Rockford, IL

Practice location

Address: 1422 E State St APT # 5, Rockford, IL 61104-2338
Phone: (414) 702-0234

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 209.010905 (IL)

Other Nurse Anesthetist, Certified Registered providers in Illinois →

Registry record

NPI: 1417387119
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Nov 2013
Record last updated: 15 Nov 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.