Healthcare Provider Details

I. General information

NPI: 1528537602
Provider Name (Legal Business Name): SHAWN POLICARPO DEUTSCH FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2018
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 TOWNSHIP LINE RD STE 200
YARDLEY PA
19067-5564
US

IV. Provider business mailing address

777 TOWNSHIP LINE RD STE 200
YARDLEY PA
19067-5564
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-0775
  • Fax: 215-860-0429
Mailing address:
  • Phone: 215-860-0775
  • Fax: 215-860-0429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP019799
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN599887
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: