Individual
GARY LYNN EDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6212
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
30042432
KY
367500000X
Certified Registered Nurse Anesthetist
4232A
KY
367500000X
Certified Registered Nurse Anesthetist
APRN59696-CRNA
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000332142
ANTHEM BLUE CROSS BLUE SHIELD
KY
05
—
2497696
—
OH
05
—
3810000822
—
WV
05
—
74011495
—
KY
Enumeration date
03/21/2006
Last updated
12/02/2021
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