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General NPI Number Information
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NPI Number | 1235155201
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Entity Type | Individual
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Provider Name | WILLIAM SHREWSBERRY CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 454 MCDOWELL ST
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City | WELCH
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State | WV
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Zip | 24801-2029
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Country | US
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Telephone | 304-436-8461
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 634712
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City | CINCINNATI
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State | OH
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Zip | 45263-0001
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Country | US
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Telephone |
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | 39835
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 35607
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License Number State | WV
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