Individual
SHAKELAH AHMADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3018
(215) 456-7170
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-7170
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP023120
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
SP023120
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669139887
—
PA
Enumeration date
11/22/2021
Last updated
08/08/2025
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