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

Individual provider Certified Registered Nurse Anesthetist · NPI 1891805503

Eddie J Wickline, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Elkhart, Indiana. Qualified in 1987, 39 years ago. Practices with Orthopedic and Sports Medicine Center of Northern Indiana Inc, a 48-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
39
Licensed in
IN
In the registry since
2006
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

2310 California Rd Ste A
Elkhart, IN 46514-1228
Phone: (574) 264-0791
Fax: (574) 262-9650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 28137996A (IN)

Record details

NPI number1891805503
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedAugust 30, 2006
Last updated in NPPESOctober 12, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Orthopedic And Sports Medicine Center Of Northern Indiana Inc — 48 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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