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Individual

SHANNON J WOZNICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
609 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(479) 751-5711
(479) 751-1099
Mailing address
601 W MAPLE AVE STE 503, SPRINGDALE, AR 72764-5376
(479) 751-3722
(479) 751-1099

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
219596
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020670570002
PA
01
11971038
CAQH
PA
01
127186
GEISINGER
PA
01
1585281
GATEWAY
PA
01
2104400
HIGHMARK
PA
01
3713583000
IBC
PA
01
50085971
CAPITAL ADVANTAGE
PA
01
9720452
AETNA
PA
Enumeration date
11/13/2007
Last updated
06/27/2022
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