Healthcare Provider Details

I. General information

NPI: 1780132464
Provider Name (Legal Business Name): JESSICA HAMETZ-SHENK DNP,BSN,CRNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 MALL CIRCLE DR
MONROEVILLE PA
15146-2207
US

IV. Provider business mailing address

421 MALL CIRCLE DR
MONROEVILLE PA
15146-2207
US

V. Phone/Fax

Practice location:
  • Phone: 412-822-1707
  • Fax:
Mailing address:
  • Phone: 412-822-1707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP016551
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: