Provider Demographics
NPI:1659349892
Name:ALBERTI, SHAWN K (CRNA)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:K
Last Name:ALBERTI
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 1:500 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5302
Mailing Address - Country:US
Mailing Address - Phone:501-664-4532
Mailing Address - Fax:501-663-4335
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 505
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-664-4532
Practice Address - Fax:501-663-4335
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC02623367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR161090001OtherMEDICAID
TX341793303OtherMEDICAID
TX8621UKOtherBCBS
TXP01536071OtherRAIL ROAD
TX75-0818167-015OtherTRICARE
ARP00312115OtherMEDICARE RAILROAD
AR5Y852OtherBLUE CROSS BLUE SHIELD
TXP01536071OtherRAIL ROAD
TX341793303OtherMEDICAID