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Individual

SHANNON KOLUPAEVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
800 LAKESHORE DR, BIRMINGHAM, AL 35229-0002
(775) 560-8000
Mailing address
5400 BROOKMEADOW LN, RENO, NV 89511-9000

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
1-166204
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
64423
ID

Other

Enumeration date
03/24/2020
Last updated
06/02/2020
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