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General NPI Number Information
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NPI Number | 1386426724
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Entity Type | Individual
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Provider Name | KRISTIN SHAUB CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 2112 HARRISBURG PIKE STE 312
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City | LANCASTER
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State | PA
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Zip | 17601-2644
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Country | US
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Telephone | 717-544-3022
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Fax |
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Provider Business Mailing Address
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Address Line | 92 JMR CIR
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City | HERSHEY
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State | PA
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Zip | 17033-1769
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Country | US
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Telephone | 717-877-5898
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP028405
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License Number State | PA
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