Individual
MR. ANTHONY RUSSELL SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
3311 E. MURDOCK, WICHITA, KS 67208
(316) 689-9107
Mailing address
3311 E. MURDOCK, WICHITA, KS 67208
(316) 689-9107
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-76946-012
KS
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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