Individual
SHANNON R EDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 GARFIELD AVE, PARKERSBURG, WV 26101-5340
(304) 424-2590
(304) 422-3924
Mailing address
601 AVERY ST STE 501, PARKERSBURG, WV 26101-5192
(304) 422-3904
(304) 422-3924
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
21306
WV
367500000X
Certified Registered Nurse Anesthetist
NA06071
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067769000
—
WV
05
—
0767433
—
OH
Enumeration date
10/03/2005
Last updated
08/29/2022
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