Individual
SHAWNA PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
334 MAIN ST, DICKSON CITY, PA 18519-1668
(570) 307-1767
(570) 307-1778
Mailing address
334 MAIN ST, DICKSON CITY, PA 18519-1668
(570) 307-1767
(570) 307-1778
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA056542
PA
363AS0400X
Surgical Physician Assistant
MA056542
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1113405
NCCPA NUMBER
—
01
—
MA056542
PA LICENSE
PA
Enumeration date
10/15/2013
Last updated
01/25/2017
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