Diane M Wild, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R1201400 Issued in MN

Practice address

333 Smith Ave N
Saint Paul, MN 55102-2344

Phone

(651) 735-0501

Fax

(651) 735-1870

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Certified Anesthesia Care, Co.

  • Certified Registered Nurse Anesthetist
  • Stillwater, MN
  • NPI 1699736348

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Metropolitan Anesthesia Network, LLP

  • Anesthesiology Physician
  • Plymouth, MN
  • NPI 1558314427

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• St Cloud Outpatient Surgery LTD

  • Ambulatory Surgical Clinic/Center
  • Saint Cloud, MN
  • NPI 1124084843
  Medicare reassignment NPD
• St Cloud Outpatient Surgery LTD

  • Certified Registered Nurse Anesthetist
  • Saint Cloud, MN
  • NPI 1720235419

  Nurse Anesthetist, Certified Registered

  NPD
• Associated Anesthesiologists PA

  • Anesthesiology Physician
  • Lake Elmo, MN
  • NPI 1780610139

  Nurse Anesthetist, Certified Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1255439782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8681 EAGLE POINT BLVD",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428628",
            "telephone_number": "651-251-8021",
            "fax_number": "651-251-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-735-0501",
            "fax_number": "651-735-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "DIANE",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1201400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "564103900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wild River Services
• Wild River Services
• Wild River Services Inc
• Wild River Services Inc
• Wild Tree Psychotherapy, LLC
• Laura Wild, D.D.S.
• Rebecca Wild Wild, RN
• Bex Wilde
• Morell Marie Wilde
• Wildenauer Chiropractic Clinic LTD

• Certified Registered Nurse Anesthetist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.