Individual
MRS. SHANNON LEA DEL GRANDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
775 E LANCASTER AVE, SUITE 200, VILLANOVA, PA 19085-1529
(610) 525-7800
(610) 525-7801
Mailing address
775 E LANCASTER AVE, SUITE 200, VILLANOVA, PA 19085-1529
(610) 525-7800
(610) 525-7801
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA057827
PA
363AS0400X
Surgical Physician Assistant
C5-0000845
DE
Other
Enumeration date
10/16/2012
Last updated
08/17/2016
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