Provider Demographics
NPI:1295046720
Name:ALONGI, WAYNE R (CRNA)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:R
Last Name:ALONGI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 WISCONSIN
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-5806
Mailing Address - Country:US
Mailing Address - Phone:985-285-3794
Mailing Address - Fax:
Practice Address - Street 1:4213 WISCONSIN
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-5806
Practice Address - Country:US
Practice Address - Phone:985-285-3794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010021569367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered