Provider Demographics
NPI:1669718789
Name:D'ANDREA, SHANA M (CRNA)
Entity type:Individual
Prefix:
First Name:SHANA
Middle Name:M
Last Name:D'ANDREA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7291
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-777-8950
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:93 CAMPUS AVE
Practice Address - Street 2:ST MARY'S ANESTHESIA ASSOCIATES
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6030
Practice Address - Country:US
Practice Address - Phone:207-755-3715
Practice Address - Fax:207-755-3728
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2019-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MERNA123053367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered