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General NPI Number Information
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NPI Number | 1932733128
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Entity Type | Individual
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Provider Name | STACEY SHANKLE CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 429 4TH AVE
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City | PITTSBURGH
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State | PA
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Zip | 15219-1500
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Country | US
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Telephone | 888-731-8994
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Fax |
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Provider Business Mailing Address
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Address Line | 429 4TH AVE FL 7
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City | PITTSBURGH
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State | PA
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Zip | 15219-1500
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Country | US
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Telephone | 888-731-8994
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Fax | 833-775-1861
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | SP021548
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License Number State | PA
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