| John L Waller, CRNA | |
|
618 S Main St, Reidsville, NC 27320-5020 | |
| (336) 951-4000 | |
| Not Available |
| Full Name | John L Waller |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 39 Years |
| Location | 618 S Main St, Reidsville, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427105980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 038610 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wilkes Regional Medical Center | North wilkesboro, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wake Forest University Health Sciences | 4486564952 | 2274 |
| Entity Name | Wake Forest University Health Sciences |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436 |
| Mailing Address | Practice Location Address |
|---|---|
| John L Waller, CRNA Po Box 26580, Greensboro, NC 27415-6580 Ph: (336) 832-7786 | John L Waller, CRNA 618 S Main St, Reidsville, NC 27320-5020 Ph: (336) 951-4000 |
Karen E Daniel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 618 S Main St, Reidsville, NC 27320 Phone: 336-951-4000 | |
Amy Andraza Adams, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 618 S Main St, Reidsville, NC 27320 Phone: 336-832-7000 | |
Robert J Idacavage, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 618 S Main St, Reidsville, NC 27320 Phone: 336-951-4000 |