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MRS. CONNIE MICHELLE SHIVELY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1118 S FARMERVILLE ST, RUSTON, LA 71270-5914
(318) 723-2770
(318) 232-1092
Mailing address
420 RISER RD, RUSTON, LA 71270-9131
(318) 232-7700
(318) 232-1092

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
60181
LA

Other

Enumeration date
02/27/2007
Last updated
08/14/2007
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