Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wilderness Trace Anesthesia, PLLC

Organization Certified Registered Nurse Anesthetist · NPI 1669742029

Wilderness Trace Anesthesia, PLLC is a Certified Registered Nurse Anesthetist in Danville, Kentucky. Licensed in Kentucky. Registered with an NPI since 2012.

Licensed in
KY
In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

210 S 2nd St
Danville, KY 40422-1804
Phone: (859) 236-4008
Fax: (859) 236-5025
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 0805370 (KY)

Record details

NPI number1669742029
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Mitchell — Managing Member · (843) 651-2624
NPI enumeratedJanuary 3, 2012
Last updated in NPPESJanuary 3, 2012
Mailing addressPo Box 4860, Murrells Inlet, SC 29576-2698

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