Healthcare Provider Details

I. General information

NPI: 1336791656
Provider Name (Legal Business Name): SHAYNA DEBARROS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

1566 JENSEN AVE
DUPONT WA
98327-8709
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4455
  • Fax:
Mailing address:
  • Phone: 954-294-9977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR234864
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: