MEDICARE: SUZANNE SHORES CNM, FNP

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	367A00000X	Advanced Practice Midwife	NC353	NC
2	367A00000X	Advanced Practice Midwife	ACNM11827	NC
3	367A00000X	Advanced Practice Midwife	MW010323	PA
4	363LF0000X	Family Nurse Practitioner	SP026928	PA

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	:	1558356337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE SHORES CNM, FNP

Provider Business Mailing Address
First Line	:	4090 BRECKENRIDGE DR
Second Line	:
City	:	PRESTO
State	:	PA
Zip	:	15142-1132
Country	:	US
Telephone Number	:	336-601-6048
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 HALKET ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3108
Country	:	US
Telephone Number	:	412-641-3419
Fax Number	:	412-641-1133

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	07/31/2025

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