Individual
JOHN PAUL SHANDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
115 E 52ND ST, KEARNEY, NE 68847-0502
(308) 236-5506
(308) 236-7089
Mailing address
PO BOX 1771, KEARNEY, NE 68848-1771
(308) 236-5506
(308) 236-7089
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
63680
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
101125
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47068752615
—
NE
Enumeration date
04/22/2010
Last updated
12/13/2023
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