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NPI Code Detail

MEDICARE: STACEY SHANKLE CRNP

MEDICARE: STACEY SHANKLE CRNP
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
1363LW0102XWomen's Health Nurse PractitionerSP021548PA

General Provider Information

NPI Number : 1932733128
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY SHANKLE CRNP
Provider Business Mailing Address
First Line : 429 4TH AVE FL 7
Second Line :
City : PITTSBURGH
State : PA
Zip : 15219-1500
Country : US
Telephone Number : 888-731-8994
Fax Number : 833-775-1861
Provider Business Practice Location Address
First Line : 429 4TH AVE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15219-1500
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2020
Last Update Date : 05/20/2026

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