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Individual

KIRK ROBERT SHELLEY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-8000
Mailing address
11 SETTLERS PT, SAVANNAH, GA 31406-3235
(864) 630-7431

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN282650
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN282650
GA

Other

Enumeration date
01/15/2019
Last updated
02/15/2022
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