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General NPI Number Information
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NPI Number | 1356826028
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Entity Type | Individual
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Provider Name | CARA EILEEN SHAW CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/28/2018
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 6915 GARBER RD
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City | BELLVILLE
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State | OH
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Zip | 44813-8987
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Country | US
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Telephone | 419-512-6533
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Fax |
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Provider Business Mailing Address
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Address Line | 6915 GARBER RD
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City | BELLVILLE
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State | OH
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Zip | 44813-8987
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Country | US
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Telephone | 419-512-6533
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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 | APRN.CRNA.019770
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License Number State | OH
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