Healthcare Provider Details

I. General information

NPI: 1881863942
Provider Name (Legal Business Name): SHANA L FLEECE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 BERNVILLE RD
READING PA
19605-9453
US

IV. Provider business mailing address

30 HOPE DR STE 2400
HERSHEY PA
17033-2036
US

V. Phone/Fax

Practice location:
  • Phone: 610-378-2000
  • Fax: 602-406-6132
Mailing address:
  • Phone: 717-531-5638
  • Fax: 717-531-0983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA056785
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT003146
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: