Individual
DEBORAH SHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
Mailing address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN201971L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227757000
KEYSTONE
PA
01
—
2321039000
IBC
PA
01
—
7814015
AETNA
PA
Enumeration date
10/04/2006
Last updated
05/09/2008
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