Provider Demographics
NPI:1245786599
Name:SHOTTS, LILIAN (CRNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LILIAN
Middle Name:
Last Name:SHOTTS
Suffix:
Gender:F
Credentials:CRNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-357-7196
Mailing Address - Fax:724-357-7279
Practice Address - Street 1:835 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3629
Practice Address - Country:US
Practice Address - Phone:724-357-8127
Practice Address - Fax:724-357-8132
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH023564363LF0000X
PASP016211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily