Wallace L Blore, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Lititz, PA
NPI 1932146644 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1932146644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RN219133L (PA)
- Practice address
- 1500 Highlands Dr
Lititz, PA 17543-7694 - Phone
- (717) 625-5000
- NPI assigned
- Jun 1, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN219133L | PA | Yes |
Addresses
Primary practice location
1500 Highlands Dr
Lititz, PA 17543-7694
Mailing address
1500 Highlands Dr
Lititz, PA 17543-7694
Phone (717) 625-5000
Other providers in Lititz, PA
- Karen Jean Bewley
- Sandra Sue Beyer
- Brooke Anna Bias
- Dolores Bievenour
- Claudia A Blackburn
- Bluebird Counseling Center LLC
- Jessica Bodene
- Lucineia Boesing
- Janae Bollinger
- Elizabeth Borders
All providers in Lititz, PA · Certified Registered Nurse Anesthetist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.