Provider Demographics
NPI:1447489794
Name:FLETCHER, JOANNA F (CRNA)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:F
Last Name:FLETCHER
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:RUNYON
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:423 WOODBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-9731
Mailing Address - Country:US
Mailing Address - Phone:304-541-4737
Mailing Address - Fax:
Practice Address - Street 1:423 WOODBRIDGE DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-9731
Practice Address - Country:US
Practice Address - Phone:304-541-4737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-030532367500000X
SC22796367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered