Healthcare Provider Details

I. General information

NPI: 1780651364
Provider Name (Legal Business Name): SHIRLEY B TERENCHIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHIRLEY BUCHER-LEE CRNP

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 09/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 W 2ND AVE
LITITZ PA
17543-1816
US

IV. Provider business mailing address

562 W 2ND AVE
LITITZ PA
17543-1816
US

V. Phone/Fax

Practice location:
  • Phone: 717-626-2167
  • Fax: 717-626-1915
Mailing address:
  • Phone: 717-626-2167
  • Fax: 717-626-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVP000778B
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier50052503
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCAPITAL BLUE CROSS
# 2
IdentifierS62056
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHEALTH ASSURANCE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: