Individual
SHANNON R EDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
21306
WV
367500000X
Certified Registered Nurse Anesthetist
NA06071
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067769000
—
WV
05
—
0767433
—
OH
Enumeration date
10/03/2005
Last updated
08/29/2022
Update your record
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