Individual provider · NPI-1

Matthew Anderson, CRNA

Nurse Anesthetist, Certified Registered · Morgantown, WV

NPI number1891266524
StatusActive
Last updated in NPPESDec 27, 2019

Details

NPI
1891266524
Entity type
Individual (NPI-1)
Name
Mr. Matthew Anderson
Credential
CRNA
Sex
Male
Sole proprietor
No
Enumeration date
Dec 6, 2018
Certification date
Dec 27, 2019
Last updated
Dec 27, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered124997WVYes
163WF0300X Registered Nurse, Flight78163WV

Other names

  • Matthew Anderson (Professional Name)

Practice location

1 Medical Center Dr
Morgantown, WV 26506-1200

Phone 304-312-5586

Mailing address

50 Hidden View Ln
Moundsville, WV 26041-1378

Phone 304-312-5586

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