Provider Demographics
NPI:1811938137
Name:CASH, AMY GOULD (CRNA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:GOULD
Last Name:CASH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:SARAH
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:26 WATERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-2997
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 J D ANDERSON DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3494
Practice Address - Country:US
Practice Address - Phone:800-394-4445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201976367500000X
FLARNP9398785367500000X
WV50861367500000X
WVAPRN58061-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVQ56927AOtherMEDICARE
WV270052997003OtherTRICARE
WVDA0096OtherRR MEDICARE
WV2602067000Medicaid
WV270052997004OtherTRICARE
WV0207026000Medicaid
WV9333201OtherMEDICARE GROUP
WV001720721OtherMSBCBS
WVDA0096OtherRR MEDICARE
OH2398374Medicaid
WV270052997000OtherBRICKSTREET
WV0207026000Medicaid
WV9333201Medicare PIN
OH2960484Medicaid