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General NPI Number Information
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NPI Number | 1467497388
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Entity Type | Individual
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Provider Name | GRAHAM N STANLEY CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 2520 VALLEY DR PLEASANT VALLEY HOSPITAL
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City | POINT PLEASANT
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State | WV
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Zip | 25550
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Country | US
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Telephone | 304-674-2403
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Fax | 304-675-2240
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Provider Business Mailing Address
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Address Line | PO BOX 711841 MID- ATLANTIC ANESTHESIA CONSULTANTS
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City | COLUMBUS
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State | OH
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Zip | 43271-0001
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Country | US
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Telephone | 304-346-9400
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Fax | 304-720-8461
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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 | 22005
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | NA00758
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 142485
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License Number State | OH
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