Individual
SHA'QUAYLA JEAN DE RENOUARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4815 LIBERTY AVE STE 425, PITTSBURGH, PA 15224-2156
(412) 359-4352
Mailing address
4815 LIBERTY AVE STE 425, PITTSBURGH, PA 15224-2156
(412) 359-4352
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA060373
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15058650
CAQH
—
Enumeration date
03/14/2019
Last updated
01/11/2021
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