Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RANDY RAY WIENTJES, C.R.N.A.
Active Sole ProprietorMR. RANDY RAY WIENTJES, C.R.N.A. is a Certified Nurse Anesthetist (CRNA) healthcare provider located in METROPOLIS, Illinois. NPI 1154352045 is currently active in the NPPES registry. Verify at CMS.
Certified Nurse Anesthetist (CRNA) · METROPOLIS, IL
Registration Details
- NPI Number
- 1154352045
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 6, 2006 (20.154477924303 yrs)
- Last Updated
- Sep 9, 2015
- Licenses
-
209-004142 (IL)CR000381 (SD)3001002 (KY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3042 LAKEVIEW DRMETROPOLIS, IL, 629603119Browse IL providers · Browse ZIP 62960
- Phone
- 6185249217
- Fax
- 6185242158
- Primary Specialty
-
Certified Nurse Anesthetist (CRNA)
367500000X
- Additional Specialty
- Certified Nurse Anesthetist (CRNA)
- Additional Specialty
- Certified Nurse Anesthetist (CRNA)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.