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General NPI Number Information
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NPI Number | 1689247207
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Entity Type | Individual
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Provider Name | YALIXSA THEN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 624 W CENTRE ST
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City | SHENANDOAH
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State | PA
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Zip | 17976-1403
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Country | US
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Telephone | 570-671-0300
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Fax | 570-671-0305
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Provider Business Mailing Address
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Address Line | 100 SHENANGO AVE
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City | SHARON
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State | PA
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Zip | 16146-1503
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Country | US
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Telephone | 570-671-0300
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Fax | 570-671-0305
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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 | F347683
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP032479
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License Number State | PA
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