Provider Demographics
NPI:1245024595
Name:WILD, JOSHUA (CRNA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:WILD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 S 70TH STREET
Mailing Address - Street 2:SUITE # 250
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3693
Mailing Address - Country:US
Mailing Address - Phone:402-489-4186
Mailing Address - Fax:402-489-5279
Practice Address - Street 1:2900 S 70TH STREET
Practice Address - Street 2:SUITE # 250
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3693
Practice Address - Country:US
Practice Address - Phone:402-489-4186
Practice Address - Fax:402-489-5279
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE90950163W00000X
NE101931367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse