MEDICARE: MRS. ASHLEY J SHIELDS HEALTH PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1083421432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY J SHIELDS HEALTH PRACTITIONER

Provider Business Mailing Address
First Line	:	217 FALON LN # 1008
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-6542
Country	:	US
Telephone Number	:	814-386-3295
Fax Number	:

Provider Business Practice Location Address
First Line	:	412 S WASHINGTON ST
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066-1586
Country	:	US
Telephone Number	:	814-386-3295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	12/18/2024

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