Individual
PATRICIA A. AMMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
(681) 342-1610
(681) 342-1626
Mailing address
PO BOX 6209, WHEELING, WV 26003-0714
(304) 233-2455
(304) 233-6073
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
65840
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38100122315
MEDICAID
WV
01
—
Q38547A
MEDICARE PTAN
WV
Enumeration date
01/19/2012
Last updated
05/20/2014
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