Provider Demographics
NPI:1134186810
Name:MONRAD, WENDY LYNN (CRNA)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNN
Last Name:MONRAD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:PROF
Other - First Name:WENDY
Other - Middle Name:LYNN
Other - Last Name:ARONSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:4810 SOUTHPARK BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-4845
Mailing Address - Country:US
Mailing Address - Phone:907-360-7916
Mailing Address - Fax:
Practice Address - Street 1:4810 SOUTHPARK BLUFF DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-4845
Practice Address - Country:US
Practice Address - Phone:907-360-7916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY15444163W00000X
AK22342163W00000X
TX674195163W00000X
AK250367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRNA0035Medicaid
AKRNA0035Medicaid
AK8EB836Medicare PIN