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NPI Code Detail

MEDICARE: BRENDA K MARCUM CRNA

MEDICARE: BRENDA K MARCUM CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN0000076353TN
2163W00000XRegistered Nurse22816WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316939283
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA K MARCUM CRNA
Provider Business Mailing Address
First Line : PO BOX 189
Second Line :
City : HORNER
State : WV
Zip : 26372-0189
Country : US
Telephone Number : 304-269-0878
Fax Number : 304-269-8090
Provider Business Practice Location Address
First Line : 230 HOSPITAL PLZ
Second Line :
City : WESTON
State : WV
Zip : 26452-8558
Country : US
Telephone Number : 304-269-8090
Fax Number : 304-269-8090
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 09/11/2025

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Directions to “ BRENDA K MARCUM CRNA” Practice Location

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