Individual
SHAHA IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0001
(814) 877-2938
Mailing address
201 STATE ST, ERIE, PA 16550-0001
(814) 877-2938
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN650013
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
151606
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN650013
PA RN LICENSE
PA
Enumeration date
07/10/2023
Last updated
06/12/2024
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