Individual
SHAUNE CORRINNE SOUTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-8000
Mailing address
2763 TOWNSHIP RD, RIEGELSVILLE, PA 18077-9520
(215) 718-4997
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
147127
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN563642
PA
Other
Enumeration date
03/08/2023
Last updated
02/13/2024
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