Provider Demographics
NPI:1972735033
Name:OVERGAARD, SHAWN MICHAEL (CRNA)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:MICHAEL
Last Name:OVERGAARD
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:2101 SEURER ST
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MN
Mailing Address - Zip Code:55054-5441
Mailing Address - Country:US
Mailing Address - Phone:952-461-6196
Mailing Address - Fax:952-461-6196
Practice Address - Street 1:800 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-4575
Practice Address - Country:US
Practice Address - Phone:507-238-8110
Practice Address - Fax:507-238-8686
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2024-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNR 135182-6367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered