Healthcare Provider Details

I. General information

NPI: 1285570309
Provider Name (Legal Business Name): SHANNON BACHETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 SCHOOL LN
SPRINGFIELD PA
19064-2518
US

IV. Provider business mailing address

103 SCHOOL LN
SPRINGFIELD PA
19064-2518
US

V. Phone/Fax

Practice location:
  • Phone: 484-337-4700
  • Fax:
Mailing address:
  • Phone: 484-337-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN589215
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: