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Individual

ANDREA M SHAUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
639 MAIN ST, JOHNSON CITY, NY 13790-1805
(607) 770-1988
(607) 770-1988
Mailing address
71 HOSPITAL DR, TOWANDA, PA 18848-9702
(570) 265-6300
(570) 268-2807

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F382793-1
NY
363LP0200X
Pediatric Nurse Practitioner
SP017960
PA

Other

Enumeration date
06/12/2018
Last updated
11/12/2024
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