Individual
JEFFERY D AMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
101 STADIUM DR, MORGANTOWN, WV 26506-7911
(304) 598-4000
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
51199
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810011467
—
WV
01
—
CA7030
RAILROAD MEDICARE GROUP
WV
01
—
P00471911
RAILROAD MEDICARE
WV
Enumeration date
11/29/2007
Last updated
10/22/2008
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