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Individual

KELLIE T SHANHOLTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-8000
(540) 536-7681
Mailing address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-8000
(540) 536-7681

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024134809
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
AC002767
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2604151000
WV
Enumeration date
02/28/2006
Last updated
07/17/2019
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