Individual
MRS. SHAWNA COLLEEN WATERSTRADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
611 W. PARK ST., ANESTHESIOLOGY, URBANA, IL 61801-2500
(217) 383-3303
(217) 383-3265
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.391110
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209013803
IL
Other
Enumeration date
10/26/2015
Last updated
07/21/2022
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