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Individual

JESSICA ANNE EGNOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
100 ANGUS E PEYTON DR, SOUTH CHARLESTON, WV 25303-1600
(615) 545-6495
Mailing address
307 FAIRVIEW DR, HURRICANE, WV 25526-1711
(615) 545-6495

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
119870
WV
390200000X
Student in an Organized Health Care Education/Training Program
84457
WV

Other

Enumeration date
04/09/2022
Last updated
06/20/2024
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