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NPI Code Detail

MEDICARE: SHAINA SHADLE RN

MEDICARE: SHAINA SHADLE RN
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
1163WM0102XMaternal Newborn Registered NurseRN639478PA

General Provider Information

NPI Number : 1215424551
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAINA SHADLE RN
Provider Business Mailing Address
First Line : 3417 N FRONT ST APT 3
Second Line :
City : WHITEHALL
State : PA
Zip : 18052-3169
Country : US
Telephone Number : 570-317-7183
Fax Number :
Provider Business Practice Location Address
First Line : 424 SAVANNAH RD
Second Line :
City : LEWES
State : DE
Zip : 19958-1462
Country : US
Telephone Number : 570-317-7183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2018
Last Update Date : 04/20/2018

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