Individual provider · Type 1 NPI

Cameron Blake Wallace, CRNA

Certified Registered Nurse Anesthetist · Charleston, WV

NPI number 1174456578 Active

Practice location

3200 Maccorkle Ave SE
Charleston, WV 25304-1227

Mailing address

4188 8th Street Rd
Huntington, WV 25701-9440

Specialties and licenses

TaxonomyCodeLicense
Certified Registered Nurse Anesthetist Primary 367500000X109296 (WV)

Certified Registered Nurse Anesthetist: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of creden…

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About NPI 1174456578

Cameron Blake Wallace, CRNA's National Provider Identifier is 1174456578, issued on Jun 4, 2026. The primary taxonomy on file is Certified Registered Nurse Anesthetist (367500000X), and the practice location is in Charleston, WV. The record was last updated on Aug 3, 2026.