MEDICARE: CHARLENE K. ESHLEMAN RN, CS

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	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	RN255392L	PA

General Provider Information

NPI Number	:	1437372349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLENE K. ESHLEMAN RN, CS

Provider Business Mailing Address
First Line	:	822 MARIETTA AVE
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3239
Country	:	US
Telephone Number	:	717-399-8288
Fax Number	:	717-399-8968

Provider Business Practice Location Address
First Line	:	822 MARIETTA AVE
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3239
Country	:	US
Telephone Number	:	717-399-8288
Fax Number	:	717-399-8968

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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