Individual
MRS. JENNIFER LYNN BYUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CRNA
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-4077
(304) 388-9852
Mailing address
PO BOX 1547, CAMC PROVIDER ENROLLMENT, CHARLESTON, WV 25326-1547
(304) 388-1724
(304) 388-1721
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN57402
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001389
—
WV
01
—
P00180969
RR MEDICARE
WV
Enumeration date
10/24/2006
Last updated
04/22/2019
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