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NPI Code Detail

MEDICARE: JANICE A SHORE CRNA

MEDICARE: JANICE A SHORE CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist079178MO

General Provider Information

NPI Number : 1427051846
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE A SHORE CRNA
Provider Business Mailing Address
First Line : 100 HOSPITAL DR
Second Line :
City : LEBANON
State : MO
Zip : 65536-9210
Country : US
Telephone Number : 800-277-8151
Fax Number : 336-841-6217
Provider Business Practice Location Address
First Line : 100 HOSPITAL DR
Second Line :
City : LEBANON
State : MO
Zip : 65536-9210
Country : US
Telephone Number : 800-277-8151
Fax Number : 336-841-6217
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 07/08/2007

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