Individual
MICHELLE L STOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
52711
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706470
MSBCBS
WV
01
—
001721843
BCBS
WV
05
—
0207026000
—
WV
01
—
233080009300
OHIO WORKERS' COMP
OH
05
—
2435118
—
OH
05
—
2460484
—
OH
05
—
2605278000
—
WV
01
—
27005299700
BRICKSTREET
WV
01
—
270052997002
TRICARE
WV
01
—
DA0096
RR MEDICARE
WV
01
—
P00158674
RR MEDICARE
WV
Enumeration date
06/09/2006
Last updated
02/06/2017
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