=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649687500
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHEILA LABADIE CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2014
-----------------------------------------------------
Last Update Date | 04/04/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1650 HUNTINGDON PIKE SUITE 256
-----------------------------------------------------
City | MEADOWBROOK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19046-8004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-837-4597
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 131 LARK DR
-----------------------------------------------------
City | HOLLAND
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18966-1943
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP017061
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------