Healthcare Provider Details

I. General information

NPI: 1356221527
Provider Name (Legal Business Name): SHELBY HONTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2025
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2841 HARRISBURG PIKE
LANCASTER PA
17601-1802
US

IV. Provider business mailing address

2841 HARRISBURG PIKE
LANCASTER PA
17601-1802
US

V. Phone/Fax

Practice location:
  • Phone: 223-287-9000
  • Fax:
Mailing address:
  • Phone: 223-287-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN695163
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: