Most Relevant Information
Provider Data
| NPI Number: | 1003052499 |
| Provider Name: | SHELLY RENE ERIKSSON CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 081106 |
Most Important Dates
| Enumeration Date: | 01/06/2009 |
| Last Updated: | 03/26/2009 |
Provider Practice Location
1737 BRIARCREST DR
SUITE 14
BRYAN
TX
778022769
Practice Location Phone/Fax
| Phone: | 9797764777 |
| Fax: | 9797760588 |
Provider Mailing Location
1737 BRIARCREST DR
SUITE 14
BRYAN
TX
778022769
Provider Mailing Phone/Fax
| Phone: | 9797764777 |
| Fax: | 9797760588 |