Provider Demographics
NPI:1275817587
Name:SHALLENBERGER, FLORENCE HELEN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:HELEN
Last Name:SHALLENBERGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1912
Mailing Address - Country:US
Mailing Address - Phone:814-452-1917
Mailing Address - Fax:814-455-9440
Practice Address - Street 1:2004 W 24TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-1912
Practice Address - Country:US
Practice Address - Phone:814-452-1917
Practice Address - Fax:814-455-9440
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN098591L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse