Provider Demographics
NPI:1154822278
Name:HYRE, SAMANTHA KIRK (CRNA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:KIRK
Last Name:HYRE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:KIRK
Other - Last Name:FRAME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 HOYLMAN DR.
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:WV
Mailing Address - Zip Code:26601-9411
Mailing Address - Country:US
Mailing Address - Phone:304-364-5159
Mailing Address - Fax:
Practice Address - Street 1:100 HOYLMAN DR
Practice Address - Street 2:
Practice Address - City:GASSAWAY
Practice Address - State:WV
Practice Address - Zip Code:26624-9318
Practice Address - Country:US
Practice Address - Phone:304-364-5159
Practice Address - Fax:304-364-5159
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV83745163WE0003X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WE0003XNursing Service ProvidersRegistered NurseEmergency