Basic Information
| Provider Information | |||||||||
| NPI: | 1487213245 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TREADWAY | ||||||||
| FirstName: | CIERRA | ||||||||
| MiddleName: | BROOKE | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2295 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288022295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283985244 | ||||||||
| FaxNumber: | 8283603080 | ||||||||
| Practice Location | |||||||||
| Address1: | 1710 HARPER RD | ||||||||
| Address2: | |||||||||
| City: | BECKLEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 258013357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042564100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2019 | ||||||||
| LastUpdateDate: | 06/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 103617 | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.