MEDICARE: KRISTINA SHEEHAN ANDREW REGISTERED NURSE

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	3336C0003X	Community/Retail Pharmacy	RN319849L	PA

General Provider Information

NPI Number	:	1487233391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA SHEEHAN ANDREW REGISTERED NURSE

Provider Business Mailing Address
First Line	:	104 LOWRY DR
Second Line	:
City	:	DUNCANSVILLE
State	:	PA
Zip	:	16635-7702
Country	:	US
Telephone Number	:	814-330-8106
Fax Number	:

Provider Business Practice Location Address
First Line	:	3331 PLEASANT VALLEY BLVD
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-4311
Country	:	US
Telephone Number	:	814-942-1081
Fax Number	:

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

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	04/07/2021

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Directions to “ KRISTINA SHEEHAN ANDREW REGISTERED NURSE” Practice Location

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