STACY LYN COMMODORE

MORGANTOWN, WV
NPI1639409824
Former NameSTACY L BLANKENSHIP
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: WV  62855)
Enumeration Date2010-01-11
Last Update Date2022-03-01
Business Address
Mrs. STACY LYN COMMODORE CRNA
2000 MON HEALTH MEDICAL PARK DR STE 2001
MORGANTOWN, WV 26505-1167
Phone number: 304-720-8816
Mailing Address
Mrs. STACY LYN COMMODORE CRNA
PO BOX 3466
CHARLESTON, WV 25334-3466
Phone number: 304-720-8816
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