Individual
SHANNON MARIE NICOSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
200 SCENERY DR, STATE COLLEGE, PA 16801-7974
(570) 271-6516
Mailing address
161 HARVEST HILL LN, SPRING MILLS, PA 16875-1610
(814) 360-8827
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP025407
PA
363LF0000X
Family Nurse Practitioner
346354
NY
Other
Enumeration date
08/20/2020
Last updated
11/13/2023
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