Individual
MR. BYRON RUSSELL SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
333 E 2ND ST, RICHLAND CENTER, WI 53581-1914
(608) 647-6321
Mailing address
201 N STEWART ST, RICHLAND CENTER, WI 53581-1323
(608) 647-6522
(608) 647-8010
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
46278-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4328950
—
WI
Enumeration date
09/29/2006
Last updated
07/08/2007
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