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Individual

JANICE ELIZABETH EKBERG-SHELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 982-0655
Mailing address
2195 WESTOVER DR, CHARLOTTESVILLE, VA 22901-9503
(434) 812-1008
(434) 823-1008

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001072985
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024072985
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8938229
VA
Enumeration date
12/08/2005
Last updated
12/10/2013
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