Lyea Dorae Shine
Lyea Dorae Shine is a Certified Registered Nurse Anesthetist (CRNA) in Pleasant Hope, Missouri. Qualified in 2021, 5 years ago. Practices with Agcny Physicians PLLC, a 36-clinician group and accepts Medicare assignment. Licensed in Missouri and New York.
- Years since qualifying
- 5
- Licensed in
- MO, NY
- In the registry since
- 2020
- Specialties on file
- 2
Practice location Address checks out
502 McCurry StPleasant Hope, MO 65725-9231
Phone: (904) 254-3686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Certified Registered Nurse Anesthetist (primary) | Taxonomy 367500000X · Licence 811313 (NY) |
|---|---|
| Registered Nurse | Taxonomy 163W00000X · Licence 2014029095 (MO) |
Record details
| NPI number | 1396346870 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | November 3, 2020 |
| Last updated in NPPES | June 1, 2021 |
| Certification date | June 1, 2021 |
| Mailing address | Po Box 68, Fayetteville, NY 13066-0068 |
Medicare enrollment
| Medicare specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
|---|---|
| Medical school | OTHER |
| Graduated | 2021 (5 years in practice) |
| Group practice | Agcny Physicians Pllc — 36 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |