Individual
TANYA C AMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 STADIUM DRIVE, MORGANTOWN, WV 26506
(304) 598-4800
(304) 285-7126
Mailing address
P. O. BOX 897, MORGANTOWN, WV 26507-0897
(304) 285-7100
(304) 285-7126
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
58304
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810002099
—
WV
01
—
P00318576
RAILROAD MEDICARE
WV
Enumeration date
08/23/2006
Last updated
06/05/2014
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