Pyle, Shawn Wayne

Pyle, Shawn Wayne is an individual health care provider with primary practice located at 405 W Jackson St , Carbondale IL 62901-1462. 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. Pyle, Shawn Wayne can be contacted via phone (618) 549-0721.

Contact Information

Primary practice address
405 W Jackson St Carbondale IL 62901-1462
Phone: (618) 549-0721
Fax: (618) 529-0449
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209010241 Illinois

Profile Details

NPI number 1104964519
LBN Legal business name Pyle, Shawn Wayne
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2007
Last updated Sep 28th, 2021 - about 4 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 1104964519 NPPES
Illinois Other 214881 MULTISPECIALTY PTAN

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