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Individual

MICHELLE L STOTTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
720 PINNELL ST, JACKSON GENERAL HOSPITAL, RIPLEY, WV 25271
(304) 373-1544
(304) 373-0044
Mailing address
200 HOSPITAL DR, MID ATLANTIC ANESTHESIA CONSULTANTS, SPENCER, WV 25276-1050
(304) 346-9400
(304) 345-7320

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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