Individual
SHAWN MICHAEL KOTLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1414 HONEYGOLD LN, BROADVIEW HEIGHTS, OH 44147-3630
(440) 570-4022
Mailing address
1414 HONEYGOLD LN, BROADVIEW HEIGHTS, OH 44147-3630
(440) 570-4022
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN268118 / NA06661
OH
367500000X
Certified Registered Nurse Anesthetist
RN572172
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2287583
—
OH
Enumeration date
07/27/2006
Last updated
01/10/2014
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