Individual
SANDRA K MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3800
(205) 322-1808
(205) 322-1851
Mailing address
PO BOX 714960, COLUMBUS, OH 43271-4960
(205) 322-1808
(205) 322-1851
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
30341
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067951000
—
WV
05
—
0868833
—
OH
01
—
1056111
WORKERS' COMP
WV
05
—
74414640
—
KY
01
—
P00209264
PALMETTO GBA-RR MEDICARE
—
Enumeration date
10/18/2006
Last updated
07/08/2007
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