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General NPI Number Information
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NPI Number | 1609042746
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Entity Type | Individual
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Provider Name | PAULA M SHONAK N.P.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 79 SAYLES ST
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550-1729
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Country | US
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Telephone | 508-764-6041
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Fax | 508-764-6318
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Provider Business Mailing Address
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Address Line | PO BOX 40
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550-0040
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Country | US
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Telephone | 508-909-7799
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Fax | 508-764-2432
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 213992
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN213992
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License Number State | MA
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