Individual
MR. LAWRENCE M. SHOVELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
29 SILVER SPRUCE DR, SALIDA, CO 81201-9483
(719) 325-6871
Mailing address
310 COUNTY ROAD 14, DEL NORTE, CO 81132-8719
(719) 657-4102
(719) 657-4106
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
172781
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30437873
—
CO
01
—
4702
CRNA
CO
Enumeration date
01/17/2006
Last updated
04/04/2017
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