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General NPI Number Information
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NPI Number | 1487831277
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Entity Type | Individual
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Provider Name | SHAWN SEARS CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 01/24/2008
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Provider Practice Location Address
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Address Line | 305 LANGDON ST
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City | SOMERSET
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State | KY
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Zip | 42503-2750
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Country | US
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Telephone | 606-679-7441
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Fax |
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Provider Business Mailing Address
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Address Line | 3320 TATES CREEK RD STE 204
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City | LEXINGTON
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State | KY
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Zip | 40502-3400
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Country | US
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Telephone | 859-268-1030
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Fax | 859-269-4120
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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 | 5416A
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License Number State | KY
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