Individual
DR. SHANNON TARA SCHEUREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
324 E INDEPENDENCE ST, SHAMOKIN, PA 17872-6710
(570) 648-4747
(570) 648-3100
Mailing address
419 BROAD ST, ASHLAND, PA 17921-2107
(570) 875-2504
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000131
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001760262
—
PA
01
—
397037
NVA
PA
01
—
636139
BC/BS NE PA
PA
01
—
809208
FIRST PRIORITY HEALTH
PA
Enumeration date
07/18/2006
Last updated
06/15/2009
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