Individual
CHRISTA MARIE PETKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
ONE MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506-8133
(304) 598-4156
Mailing address
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506-8133
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101309
PA
390200000X
Student in an Organized Health Care Education/Training Program
73657
WV
390200000X
Student in an Organized Health Care Education/Training Program
RN602564
PA
Other
Enumeration date
12/12/2013
Last updated
01/31/2014
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