Provider Demographics
NPI:1821452251
Name:SHAW, VALERIE S (CRNA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:S
Last Name:SHAW
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:S
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10513 ROSEWATER PKWY
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-8104
Mailing Address - Country:US
Mailing Address - Phone:402-278-2536
Mailing Address - Fax:
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PENDER
Practice Address - State:NE
Practice Address - Zip Code:68047-4507
Practice Address - Country:US
Practice Address - Phone:402-278-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101340367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered