Individual
MRS. STACY LYN COMMODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN62855
WV
Other
Enumeration date
01/11/2010
Last updated
10/21/2025
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