Individual
ALEXIS SHANABROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 NORTH ST, HANOVER, PA 17331-2275
(717) 637-7755
Mailing address
20 NORTH ST, HANOVER, PA 17331-2275
(717) 637-7755
(717) 637-7142
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA005438
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103837806
—
PA
Enumeration date
08/12/2019
Last updated
07/16/2021
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