Kotlyn, Shawn Michael

Kotlyn, Shawn Michael is an sole proprietor health care provider with primary practice located at 1414 Honeygold Ln , Broadview Heights OH 44147-3630. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Kotlyn, Shawn Michael can be contacted via phone (440) 570-4022.

Contact Information

Primary practice address
1414 Honeygold Ln Broadview Heights OH 44147-3630
Phone: (440) 570-4022
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN268118 / NA06661 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN572172 Pennsylvania

Profile Details

NPI number 1619991031
LBN Legal business name Kotlyn, Shawn Michael
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2006
Last updated Jan 10th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619991031 NPPES
Ohio MEDICAID 2287583

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