Individual
MRS. SHAUNTARA ANN ANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
361 ALEXANDER SPRING RD, CARLISLE, PA 17015-6940
(717) 960-3414
Mailing address
361 ALEXANDER SPRING RD, CARLISLE, PA 17015-6940
(717) 960-1687
(717) 960-3487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
SP018809
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
SP018809
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP018809
CRNP LICENSE
PA
Enumeration date
06/01/2018
Last updated
10/22/2024
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