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Individual
TANA JAY SHIELDS
Active
Individual
TANA JAY SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN207066
AZ
367500000X
Certified Registered Nurse Anesthetist
277707
AZ
Other
Enumeration date
02/28/2019
Last updated
07/29/2022
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