Individual
SHANNON D ELDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3550
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3550
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
675067
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP118773
TX
Other
Enumeration date
01/29/2010
Last updated
06/23/2020
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