Doctor Name: | MS. LAURA M WILD |
NPI Number: | 1770763476 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNA |
License Number: | 26NR09068200 |
Business Practice Address: | 253 Witherspoon St Princeton, NJ - 085403211 |
Business Phone Number: | 9729321302 |
Business Fax Number: | 9729321312 |
Mailing Address: | 253 Witherspoon St, PRINCETON |
State: | NJ |
Postal Code: | 085403211 |
Phone Number: | 9729321302 |
Fax Number: | 9729321312 |
NPI Enumeration Date: | 11/09/2007 |
NPI Last Update Date: | 05/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 26NR09068200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |