Provider Demographics
NPI:1841609419
Name:SUTCH, CHRISTINE A (CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:SUTCH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARPN
Mailing Address - Street 1:6040 UNIVERSITY TOWN CENTRE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507
Mailing Address - Country:US
Mailing Address - Phone:304-598-6900
Mailing Address - Fax:
Practice Address - Street 1:6040 UNIVERSITY TOWN CENTER
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501
Practice Address - Country:US
Practice Address - Phone:304-598-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014065207Q00000X
WVAPRN96628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVAPRN96228NPOtherLICENSE
PASP014065OtherLICENSE