| Mrs Wendy Amanda Gravelle, CRNA | |
|
415 Jefferson St North, Wadena, MN 56482 | |
| (218) 631-3510 | |
| (218) 631-7496 |
| Full Name | Mrs Wendy Amanda Gravelle |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 415 Jefferson St North, Wadena, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306948245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R1540705 (Minnesota) | Primary |
| Entity Name | Astera Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134305162 PECOS PAC ID: 2961395272 Enrollment ID: O20040202001082 |
| Entity Name | Perham Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932113768 PECOS PAC ID: 2264327766 Enrollment ID: O20040216000182 |
| Entity Name | Perham Hospital District |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1790799518 PECOS PAC ID: 2264327766 Enrollment ID: O20061104000612 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Wendy Amanda Gravelle, CRNA 13436 County Road 101, Wadena, MN 56482 Ph: (218) 632-5989 | Mrs Wendy Amanda Gravelle, CRNA 415 Jefferson St North, Wadena, MN 56482 Ph: (218) 631-3510 |
Rachael Lynn Spear, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 415 Jefferson St N, Wadena, MN 58482 Phone: 218-631-3510 | |
Lee Allen Ellingson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 415 Jefferson St N, Wadena, MN 56482 Phone: 218-631-7589 |