Individual
CYNTHIA GAGNON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
20 HOSPITAL DRIVE, LOGAN, WV 25601
(304) 831-1138
(304) 831-1267
Mailing address
20 HOSPITAL DRIVE, LOGAN, WV 25601
(304) 831-1138
(304) 831-1267
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
21113
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065450000
—
WV
Enumeration date
04/21/2006
Last updated
07/08/2007
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