Individual
SHANE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
674 S HIGHWAY 99, FILLMORE, UT 84631-5013
(435) 743-5591
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2776204406
UT
Other
Enumeration date
11/01/2006
Last updated
02/21/2012
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