Individual
MRS. SHELLY RENEA FAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
601 W LEOTA, NORTH PLATTE, NE 69101
(308) 696-8000
Mailing address
514 N MAPLE, NORTH PLATTE, NE 69101
(308) 534-6965
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100553
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044272
AANA #
NE
Enumeration date
08/18/2006
Last updated
07/08/2007
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