Provider Demographics
NPI:1144596396
Name:BLUNT, SHELDON HENRY (APRN)
Entity Type:Individual
Prefix:MR
First Name:SHELDON
Middle Name:HENRY
Last Name:BLUNT
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:PA
Mailing Address - Zip Code:19070-1418
Mailing Address - Country:US
Mailing Address - Phone:267-230-6534
Mailing Address - Fax:
Practice Address - Street 1:230 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1418
Practice Address - Country:US
Practice Address - Phone:267-230-6534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010818363L00000X
FL9321437163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WH0200XNursing Service ProvidersRegistered NurseHome Health