Individual
SHIANNE DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
450 ERIE ST, EDINBORO, PA 16412
(814) 734-1618
(814) 734-3102
Mailing address
450 ERIE ST, EDINBORO, PA 16412-2200
(814) 734-1618
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363AM0700X
Medical Physician Assistant
Primary
OA007016
PA
Other
Enumeration date
01/25/2019
Last updated
12/06/2024
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