Individual
MRS. SUSAN LYNN MUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-4077
Mailing address
4546 WOODRUM LN, CHARLESTON, WV 25313-2329
(304) 382-7168
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
27809
WV
Other
Enumeration date
10/19/2007
Last updated
10/19/2007
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