Healthcare Provider Details

I. General information

NPI: 1790571990
Provider Name (Legal Business Name): KATELYN E ESBENSHADE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W CHOCOLATE AVE STE 3
HERSHEY PA
17033-1568
US

IV. Provider business mailing address

250 W CHOCOLATE AVE STE 3
HERSHEY PA
17033-1568
US

V. Phone/Fax

Practice location:
  • Phone: 717-547-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT033562
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: