Individual
ELIZABETH SARAH SHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4910 FAIRFIELD RD STE A, FAIRFIELD, PA 17320-9510
(717) 339-3175
(717) 255-0950
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP016287
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103169866
—
PA
01
—
13892026
CAQH
—
01
—
1762306
RAILROAD MEDICARE
PA
Enumeration date
07/17/2016
Last updated
08/20/2024
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