Individual
MR. WILLARD JEFFREY SHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1370 W D ST, NORTH WILKESBORO, NC 28659-3506
(336) 651-8100
Mailing address
249 FAIRWAY LN, WILKESBORO, NC 28697-8543
(561) 271-2476
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
275190
NC
390200000X
Student in an Organized Health Care Education/Training Program
275190
NC
Other
Enumeration date
05/04/2015
Last updated
11/30/2018
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