Individual
MRS. SHANNON K MCCLURKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
175 E. CHESTER PIKE, RIDLEY PARK, PA 19078-2284
(215) 442-5085
(877) 329-2370
Mailing address
PO BOX 650782, DALLAS, TX 75265-0782
(302) 733-0806
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
26NR13142900
NJ
367500000X
Certified Registered Nurse Anesthetist
L1-0029265
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
RN550491
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079043
AANA
PA
05
—
102309550
—
PA
Enumeration date
01/02/2009
Last updated
10/25/2011
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