Individual
SHAWNA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Mailing address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
40823.1687
WY
367500000X
Certified Registered Nurse Anesthetist
RN.1635629
CO
Other
Enumeration date
10/08/2015
Last updated
10/05/2020
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