Provider Demographics
NPI:1700982717
Name:SPRINGER, SHAWN CHRISTOPHER (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:CHRISTOPHER
Last Name:SPRINGER
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-1238
Mailing Address - Country:US
Mailing Address - Phone:315-568-2308
Mailing Address - Fax:315-568-2308
Practice Address - Street 1:300 MERIDIAN CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3981
Practice Address - Country:US
Practice Address - Phone:585-463-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22516741282N00000X
NY430212363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No282N00000XHospitalsGeneral Acute Care Hospital