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General NPI Number Information
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NPI Number | 1003964008
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Entity Type | Individual
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Provider Name | KRISTA L SIZEMORE CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 613 CROOKED RUN RD
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City | FAYETTEVILLE
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State | WV
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Zip | 25840
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Country | US
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Telephone | 304-574-6027
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Fax | 304-574-6027
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Provider Business Mailing Address
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Address Line | PO BOX 1012
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City | PRINCETON
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State | WV
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Zip | 24740-1012
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Country | US
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Telephone | 304-574-6027
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Fax | 304-574-6027
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 48679
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License Number State | WV
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