Blumhardt, Wayde Russell

Blumhardt, Wayde Russell is an individual health care provider with primary practice located at 1825 Logan Ave , Waterloo IA 50703. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Blumhardt, Wayde Russell can be contacted via phone (319) 235-3886.

Contact Information

Primary practice address
1825 Logan Ave Waterloo IA 50703
Phone: (319) 235-3886
Fax: (319) 233-1630
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X D-074832 Iowa

Profile Details

NPI number 1528011996
LBN Legal business name Blumhardt, Wayde Russell
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Dec 10th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528011996 NPPES
Iowa MEDICAID 2062018
Iowa Other 55001
Iowa Other 42141730780
Iowa MEDICAID 3062018

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