Individual
SHANNON JOSEPH KRUMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
404 JEFFERSON ST, PELLA, IA 50219-1291
(641) 628-6634
(816) 461-6586
Mailing address
PO BOX 1660, INDEPENDENCE, MO 64055-0660
(816) 461-8288
(816) 461-6586
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
103187
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0206516
—
IA
Enumeration date
03/20/2006
Last updated
11/05/2007
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