Provider Demographics
NPI:1114960416
Name:SAYRE, BETSY L (CRNA)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:L
Last Name:SAYRE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1326
Mailing Address - Country:US
Mailing Address - Phone:304-647-6006
Mailing Address - Fax:
Practice Address - Street 1:1220 LEE ST E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1863
Practice Address - Country:US
Practice Address - Phone:304-388-1800
Practice Address - Fax:304-388-1825
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN44547367500000X
WV44547367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001721838OtherBCBS
OH2460484Medicaid
WVP00295695OtherRAILROAD MEDICARE
WV001706470OtherMSBCBS GROUP
WVP00295695OtherRR MEDICARE
WV270052997OtherBRICKSTREET
WV0207026000Medicaid
WV234046313OtherTRICARE
WV27005299700OtherWORKERS COMP
WV270052997003OtherTRICARE
OH2293834Medicaid
WV5710300000Medicaid
WVDA0096OtherRR MEDICARE
WV001706470OtherMSBCBS GROUP
WV27005299700OtherWORKERS COMP