Provider Demographics
NPI:1982041729
Name:JONES, WENDY COUCH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:COUCH
Last Name:JONES
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 1:120 SAINT ALBANS DR
Mailing Address - Street 2:APT 467
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6399
Mailing Address - Country:US
Mailing Address - Phone:252-292-5368
Mailing Address - Fax:
Practice Address - Street 1:3100 SPRING FOREST RD
Practice Address - Street 2:SUITE 130
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2880
Practice Address - Country:US
Practice Address - Phone:919-873-5933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC171946367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered