Individual
MR. JACK R SHEARER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PL, MS 515, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
144583
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010133181
—
VA
05
—
04132040
—
MS
05
—
104694231
—
MI
05
—
1472115
—
LA
05
—
157589001
—
AR
05
—
174264501
—
TX
05
—
200055730A
—
OK
05
—
200522250A
—
IN
05
—
2524076
—
OH
05
—
422400000
—
ME
05
—
4307498
—
MT
05
—
5440235
—
TN
05
—
919333104
—
MO
05
—
9572
—
KS
05
—
QAN028
—
SC
Enumeration date
06/27/2005
Last updated
10/02/2012
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