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NPI Code Detail

MEDICARE: GARY RICHARD MARREE JR. CRNA

MEDICARE: GARY RICHARD MARREE JR. 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 Anesthetist101305PA
2367500000XCertified Registered Nurse AnesthetistAPRN80675WV

General Provider Information

NPI Number : 1952738924
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY RICHARD MARREE JR. CRNA
Provider Business Mailing Address
First Line : PO BOX 3466
Second Line :
City : CHARLESTON
State : WV
Zip : 25334-3466
Country : US
Telephone Number : 304-720-8816
Fax Number : 904-494-6467
Provider Business Practice Location Address
First Line : 2000 MON HEALTH MEDICAL PARK DR STE 2001
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-1167
Country : US
Telephone Number : 304-720-8816
Fax Number : 904-494-6467
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2013
Last Update Date : 11/04/2025

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