Provider Demographics
NPI:1962848903
Name:MORLEY, WENDY ELIZABETH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:ELIZABETH
Last Name:MORLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ELIZABETH
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 255
Mailing Address - Street 2:
Mailing Address - City:BAYVIEW
Mailing Address - State:ID
Mailing Address - Zip Code:83803-0255
Mailing Address - Country:US
Mailing Address - Phone:208-683-1178
Mailing Address - Fax:
Practice Address - Street 1:504 6TH STREET
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501
Practice Address - Country:US
Practice Address - Phone:208-799-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID54691367500000X, 207LP2900X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine