Stacey L Wilson, CRNA
Nurse Anesthetist, Certified Registered in Orlando, FL. Individual provider (NPI-1).
NPI number1861435331
StatusActive
Last updated in NPPESOct 15, 2007
Details
- NPI
- 1861435331
- Entity type
- Individual (NPI-1)
- Name
- Stacey L Wilson
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2006
- Last updated
- Oct 15, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | ARNP3315182 | FL | Yes |
Other names
- Stacey L Kornbrust (Other Name)
Practice location
83 W Miller StOrlando, FL 32806-2031
Phone 321-843-9792
Mailing address
1214 E Concord StOrlando, FL 32803-5453
Phone 407-896-9500 · Fax 407-896-9585
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