Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shannon Boldenow

Individual provider Certified Registered Nurse Anesthetist · NPI 1720628357

Shannon Boldenow is a Certified Registered Nurse Anesthetist (CRNA) in Pontiac, Michigan. Qualified in 2019, 7 years ago. Practices with Northstar Anesthesia of Michigan III PLLC, a 567-clinician group. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2020
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Practice location Address checks out

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone: (248) 858-3000
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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 4704283091 (MI)

Record details

NPI number1720628357
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 12, 2020
Last updated in NPPESJanuary 12, 2020
Certification dateJanuary 12, 2020
Mailing address4840 Alton Ct, Troy, MI 48085-5044

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Northstar Anesthesia Of Michigan Iii Pllc — 567 clinicians
Accepts Medicare assignment Not indicated

Other providers in Pontiac