MEDICARE: SHARON RAVENELLE CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	VP005889V	PA

General Provider Information

NPI Number	:	1740371434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON RAVENELLE CRNP

Provider Business Mailing Address
First Line	:	3440 LEHIGH ST STE 101
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18103-7001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 LEHIGH ST STE 101
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18103-7001
Country	:	US
Telephone Number	:	484-822-5400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	12/08/2025

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