Individual
KEVIN MCSHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
Mailing address
16 LAWRENCE ST, BOSTON, MA 02116-6211
(303) 669-6401
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
79915
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2268707
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07799158
—
CO
Enumeration date
09/30/2006
Last updated
07/20/2016
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