Basic Information
| Provider Information | |||||||||
| NPI: | 1700982717 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPRINGER | ||||||||
| FirstName: | SHAWN | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39 MAPLE ST | ||||||||
| Address2: | |||||||||
| City: | SENECA FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 131481238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3155682308 | ||||||||
| FaxNumber: | 3155682308 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 MERIDIAN CENTRE BLVD | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146183981 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5854633100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2006 | ||||||||
| LastUpdateDate: | 05/12/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 22516741 | NY | N | Hospitals | General Acute Care Hospital | 363LA2100X | 430212 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.