Healthcare Provider Details

I. General information

NPI: 1811938137
Provider Name (Legal Business Name): AMY GOULD CASH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY SARAH GOULD CRNA

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 10/22/2021
Certification Date: 10/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 J D ANDERSON DR
MORGANTOWN WV
26505-3494
US

IV. Provider business mailing address

26 WATERSIDE DR
MORGANTOWN WV
26508-2997
US

V. Phone/Fax

Practice location:
  • Phone: 800-394-4445
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR201976
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9398785
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number50861
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN58061-CRNA
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: