Individual
MS. SHANNON T WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701
(605) 755-1000
Mailing address
353 FAIRMONT BLVD, ATTN MSS, RAPID CITY, SD 57701-7375
(605) 755-8107
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000730
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2184701
—
OH
Enumeration date
05/26/2006
Last updated
08/30/2018
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