Healthcare Provider Details

I. General information

NPI: 1780603878
Provider Name (Legal Business Name): SHANNON WRIGHT FEGAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 SCOTLAND AVE
CHAMBERSBURG PA
17201-1451
US

IV. Provider business mailing address

109 RAYLOC DR
HANCOCK MD
21750-1518
US

V. Phone/Fax

Practice location:
  • Phone: 717-217-4963
  • Fax: 717-217-2901
Mailing address:
  • Phone: 301-678-5187
  • Fax: 301-678-5797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA050908
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA050908
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: