Provider Demographics
NPI:1053400275
Name:WESSEL, GARY A (CRNA)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:A
Last Name:WESSEL
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:1175 S STATE ST
Mailing Address - Street 2:C O ICARE ANES
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4112
Mailing Address - Country:US
Mailing Address - Phone:302-698-9045
Mailing Address - Fax:302-698-9045
Practice Address - Street 1:655 BAY RD
Practice Address - Street 2:SUITE 5B
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4660
Practice Address - Country:US
Practice Address - Phone:302-678-4688
Practice Address - Fax:302-678-4688
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEL6OA00062367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered