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General NPI Number Information
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NPI Number | 1174571343
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Entity Type | Individual
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Provider Name | WALTER SHELTON III CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 1001 SAM PERRY BLVD MARY WASHINGTON HOSPITAL
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4453
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Country | US
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Telephone | 540-741-7614
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Fax | 540-741-7615
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Provider Business Mailing Address
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Address Line | 3676 BILLINGS ST
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City | MT PLEASANT
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State | SC
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Zip | 29466-6888
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Country | US
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Telephone | 904-557-8561
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN172500
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP1859212
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AA083444
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024166332
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License Number State | VA
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