Provider Demographics
NPI:1366499956
Name:SHANDLING, ANTOINETTE ACCARDO (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:ACCARDO
Last Name:SHANDLING
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 WILLIAMS RANCH DR
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1584
Mailing Address - Country:US
Mailing Address - Phone:970-920-1639
Mailing Address - Fax:
Practice Address - Street 1:149 WILLIAMS RANCH DR
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1584
Practice Address - Country:US
Practice Address - Phone:970-920-1639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO038572367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered