Provider Demographics
NPI:1326331109
Name:SHURDEN, NATHAN SCOTT (CRNA)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:SCOTT
Last Name:SHURDEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 W 24TH PL
Mailing Address - Street 2:APT A9
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2351
Mailing Address - Country:US
Mailing Address - Phone:785-424-5712
Mailing Address - Fax:
Practice Address - Street 1:823 SW MULVANE
Practice Address - Street 2:SUITE 210
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1679
Practice Address - Country:US
Practice Address - Phone:785-235-3451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS114793367500000X
AL1-113628367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered