Provider Demographics
NPI:1174260277
Name:PATEL, SHEETAL VAISHAL (CRNP)
Entity Type:Individual
Prefix:
First Name:SHEETAL
Middle Name:VAISHAL
Last Name:PATEL
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 1:454 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1200
Mailing Address - Country:US
Mailing Address - Phone:610-495-3330
Mailing Address - Fax:
Practice Address - Street 1:454 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1200
Practice Address - Country:US
Practice Address - Phone:610-495-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1265664544208600000X
PASP025734363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care