SHANNON NICOLE FREDERICK


Address: 14 Memorial Dr, Suite A, Doylestown, PA 18901
Phone: 2153482992

SHANNON NICOLE FREDERICK (NPI# 1194987123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1194987123
Entity Type Individual
Full Name SHANNON NICOLE FREDERICK
Credential PAC
Practice Address 14 Memorial Dr
Suite A
Doylestown
PA 18901
Mailing Address 1456 Ferry Rd
Ste 402
Doylestown
PA 18901-2307
Practice Telephone 2153482992
Practice Fax Number 2153482052
Mailing Telephone 2153482992
Mailing Fax Number 2153482052
Enumeration Date 2008-07-01
Last Update Date 2018-04-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
MA003232L PA Physician Assistants & Advanced Practice Nursing Providers

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Office Location

Street Address 14 MEMORIAL DR
SUITE A
City DOYLESTOWN
State PA
Zip Code 18901

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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821634668 Samantha Lynn Hange Physician Assistant 1456 Ferry Rd Ste 405, Doylestown, PA 18901-2391 2019-11-26
1003353046 Hahnemann University Hospital Physician Assistant 4103 Tersher Dr, Doylestown, PA 18902-5613 2017-01-29
1659654838 Rachel Angela Ditoro Physician Assistant 1456 Ferry Rd Ste 402, Doylestown, PA 18901-2307 2011-09-23
1528550464 Colleen Murphy Physician Assistant 252 W Swamp Rd Ste 41, Doylestown, PA 18901-2465 2018-06-06
1639689540 Molly Mae Nicastro Physician Assistant 708 N Shady Retreat Rd Ste 5, Doylestown, PA 18901-2503 2017-10-05
1477093870 Sarah Pullar Physician Assistant 4103 Tersher Dr, Doylestown, PA 18902-5613 2017-03-03
1154601193 Brenna Kathleen Dobson Physician Assistant 252 W Swamp Rd, Suite 41, Doylestown, PA 18901-2422 2011-08-22
1588836431 Heather M Rookstool Physician Assistant 1456 Ferry Rd, Suite 405, Doylestown, PA 18901-2391 2008-04-01
1598787418 Wendy Eaton Physician Assistant 599 W State St, Sutie 200, Doylestown, PA 18901-2567 2006-07-24
1316977481 Tsilina Grinberg Physician Assistant 599 W State St, Suite 200, Doylestown, PA 18901-2567 2006-07-04
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Competitor

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City DOYLESTOWN
Zip Code 18901

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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