Healthcare Provider Details

I. General information

NPI: 1871403352
Provider Name (Legal Business Name): SHINING HEARTS MEDICAL GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 W CITY AVE
BALA CYNWYD PA
19004-3102
US

IV. Provider business mailing address

183 W CITY AVE
BALA CYNWYD PA
19004-3102
US

V. Phone/Fax

Practice location:
  • Phone: 215-532-3929
  • Fax:
Mailing address:
  • Phone: 215-532-3929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: RASHANA GREER
Title or Position: CEO
Credential: CRNP
Phone: 215-532-3929