Individual
JAMES LLEWELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
500 W BERKELEY ST, UNIONTOWN, PA 15401-5514
(724) 430-5803
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2896
(540) 536-5100
(540) 536-0235
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
RN352375L
PA
367500000X
Certified Registered Nurse Anesthetist
85299
WV
367500000X
Certified Registered Nurse Anesthetist
R124304
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
RN352375L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050514
MEDICARE GROUP #
PA
01
—
1007307260035
MEDICAID GROUP #
PA
05
—
102319010 0003
—
PA
01
—
1821084708
NPI
—
01
—
RN352375L
LICENSE
PA
Enumeration date
09/26/2005
Last updated
08/24/2022
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