Provider Demographics
NPI:1093962367
Name:SHREWSBURY, KRISTI ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:ANN
Last Name:SHREWSBURY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:ANN
Other - Last Name:CULICERTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1613 N. HARRISON PARKWAY SUITE 200
Mailing Address - Street 2:MAILSTOP SH-9A
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2896
Mailing Address - Country:US
Mailing Address - Phone:800-437-2672
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:1710 HARPER ROAD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:304-256-4100
Practice Address - Fax:954-858-0116
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV054481367500000X
WV54481367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered