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General NPI Number Information
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NPI Number | 1316939283
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Entity Type | Individual
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Provider Name | BRENDA K MARCUM CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 230 HOSPITAL PLZ
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City | WESTON
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State | WV
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Zip | 26452-8558
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Country | US
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Telephone | 304-269-8090
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Fax | 304-269-8090
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Provider Business Mailing Address
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Address Line | PO BOX 189
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City | HORNER
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State | WV
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Zip | 26372-0189
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Country | US
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Telephone | 304-269-0878
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Fax | 304-269-8090
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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 | RN0000076353
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 22816
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License Number State | WV
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