Provider Demographics
NPI:1083369649
Name:ALBERTS, SHIRA ADINA KAMM (CRNP)
Entity Type:Individual
Prefix:
First Name:SHIRA
Middle Name:ADINA KAMM
Last Name:ALBERTS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3967
Mailing Address - Country:US
Mailing Address - Phone:610-690-5100
Mailing Address - Fax:
Practice Address - Street 1:795 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3967
Practice Address - Country:US
Practice Address - Phone:610-690-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily