Individual
MRS. VICKI TAYLOR HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 MORRIS STREET, CHARLESTON, WV 25301
(304) 388-6220
(304) 388-3604
Mailing address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 343-9809
(304) 388-3604
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN26613-CRNA
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067760000
—
WV
01
—
HA7196181
MEDICARE CAMC
WV
Enumeration date
09/21/2006
Last updated
05/03/2017
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