Provider Demographics
NPI:1467472902
Name:CARNEGIE, WENDY RAE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:RAE
Last Name:CARNEGIE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 S CRYSTAL COVE
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840
Mailing Address - Country:US
Mailing Address - Phone:517-339-1448
Mailing Address - Fax:
Practice Address - Street 1:1715 S CRYSTAL COVE
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840
Practice Address - Country:US
Practice Address - Phone:517-339-1448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704088184367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered