Individual
SHANNON IVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
228 INDEPENDENCE RD, EAST STROUDSBURG, PA 18301-9435
(570) 426-2830
Mailing address
726 MAPLE GROVE RD, MOSCOW, PA 18444-6862
(570) 237-2312
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
SP018102
PA
Other
Enumeration date
04/10/2018
Last updated
11/12/2018
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