MEDICARE: PHOEBE J HERSHENOW NP

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	363L00000X	Nurse Practitioner	AP60047367	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306800206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHOEBE J HERSHENOW NP

Provider Business Mailing Address
First Line	:	820 N CHELAN AVE
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-2028
Country	:	US
Telephone Number	:	509-663-8711
Fax Number	:

Provider Business Practice Location Address
First Line	:	1116 HWY 20
Second Line	:
City	:	WINTHROP
State	:	WA
Zip	:	98862
Country	:	US
Telephone Number	:	509-663-8711
Fax Number	:

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	06/22/2022

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