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MR. STETLER LADD SHUMWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
380 W 100 N, MONTICELLO, UT 84535
(435) 587-2116
Mailing address
2801 N BLUE MOUNTAIN RD, BLANDING, UT 84511-2012
(435) 459-2616

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
247971
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
9124570-8901
UT
367500000X
Certified Registered Nurse Anesthetist
C-APN.0102249-C-CRNA
CO

Other

Enumeration date
06/16/2021
Last updated
12/11/2024
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