Individual
SHANNON LAMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
615 RIDGE RD, ROXBORO, NC 27573-4629
(336) 503-5699
Mailing address
615 RIDGE RD, ROXBORO, NC 27573-4629
(336) 503-5699
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
166287
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
166287
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166287
CRNA LICENSE NUMBER
NC
05
—
8052121
—
NC
Enumeration date
05/12/2006
Last updated
10/11/2007
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