Provider Demographics
NPI:1831280221
Name:KOHLER, SHAUNA R (MS CRNA)
Entity Type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:R
Last Name:KOHLER
Suffix:
Gender:F
Credentials:MS CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1780
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-1780
Mailing Address - Country:US
Mailing Address - Phone:307-358-5590
Mailing Address - Fax:307-358-5590
Practice Address - Street 1:111 S 5TH STREET
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633
Practice Address - Country:US
Practice Address - Phone:307-358-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00066514OtherRAILROAD MC
WY312025OtherBCBS
WYW9575Medicare ID - Type Unspecified