Individual provider · Type 1 NPI

Stacy Lyn Commodore, CRNA

Certified Registered Nurse Anesthetist · Morgantown, WV

NPI number 1639409824 Active

Practice location

2000 Mon Health Medical Park Dr Ste 2001
Morgantown, WV 26505-1167

Fax (904) 494-6467

Mailing address

PO Box 3466
Charleston, WV 25334-3466

Specialties and licenses

TaxonomyCodeLicense
Certified Registered Nurse Anesthetist Primary 367500000XAPRN62855 (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 1639409824

Stacy Lyn Commodore, CRNA's National Provider Identifier is 1639409824, issued on Jan 11, 2010. The primary taxonomy on file is Certified Registered Nurse Anesthetist (367500000X), and the practice location is in Morgantown, WV. The record was last updated on Oct 21, 2025.