Provider Demographics
NPI:1457637159
Name:WHEELER, CHRISTOPHER SHAWN (CRNA, DMPNA)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SHAWN
Last Name:WHEELER
Suffix:
Gender:M
Credentials:CRNA, DMPNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3448 SHARON CT
Mailing Address - Street 2:
Mailing Address - City:CATLETTSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41129-9170
Mailing Address - Country:US
Mailing Address - Phone:606-922-1616
Mailing Address - Fax:
Practice Address - Street 1:2485 HIGHWAY 644
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-9242
Practice Address - Country:US
Practice Address - Phone:606-638-9451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007186367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered