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Individual

DANETTE LYNNE CROASTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
111 LONE PINE DR, MASONTOWN, WV 26542-8605
(304) 376-6557
Mailing address
111 LONE PINE DR, MASONTOWN, WV 26542-8605
(304) 376-6557

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
61484
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2830735
OH
05
3810010505
WV
Enumeration date
11/06/2007
Last updated
07/18/2016
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