Provider Demographics
NPI:1548236169
Name:SCHOLL, JO ANN (CRNA)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:ANN
Last Name:SCHOLL
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 1:30 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WV
Mailing Address - Zip Code:25130-1229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WV
Practice Address - Zip Code:25130-1229
Practice Address - Country:US
Practice Address - Phone:304-542-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21735367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0207026000Medicaid
WV001706470OtherMSBCBS GROUP
WV0067150000Medicaid
MD405887900Medicaid
WV550665912OtherTRICARE
WV001720711OtherMT STATE BCBS
OH2594232Medicaid
WV27005299700OtherBRICKSTREET
WV270052997006OtherTRICARE
WV27005299700OtherWORKERS COMP
WVDA0096OtherRR MEDICARE
OH2460484Medicaid
WVP00001158OtherRR MEDICARE
WVDA0096OtherRR MEDICARE
WV550665912OtherTRICARE