Allan Anderson, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Shelby, NC

NPI 1114017308 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1114017308
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
042412 (NC)
Practice address
201 E Grover St
Shelby, NC 28150-3917
Phone
(704) 476-7445
Fax
(704) 476-7417
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
042412NCMDCertified Registered Nurse Anesthetist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 042412 NC Yes

Addresses

Primary practice location

201 E Grover St
Shelby, NC 28150-3917

Mailing address

201 E Grover St
Shelby, NC 28150-3917
Phone (704) 476-7445

Other providers in Shelby, NC

All providers in Shelby, NC · Certified Registered Nurse Anesthetist in North Carolina

Sources for this page

Verify at the official NPI Registry.