Shaver, Randy R

Shaver, Randy R is an individual health care provider with primary practice located at 1 Hummingbird Holw , Southwick MA 01077-9530. 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. Shaver, Randy R can be contacted via phone (413) 569-0964.

Contact Information

Primary practice address
1 Hummingbird Holw Southwick MA 01077-9530
Phone: (413) 569-0964
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 9259958 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 180430 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 003788 Connecticut

Profile Details

NPI number 1164487351
LBN Legal business name Shaver, Randy R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Aug 5th, 2016 - about 8 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 1164487351 NPPES
Florida MEDICAID 309102300
Florida Other ARNP 9259958

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