Provider Demographics
NPI:1528211687
Name:SHY, DENISE MICHELLE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:MICHELLE
Last Name:SHY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 KENWOOD DR N
Mailing Address - Street 2:APARTMENT # 334
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-2448
Mailing Address - Country:US
Mailing Address - Phone:267-980-8714
Mailing Address - Fax:
Practice Address - Street 1:185 KENWOOD DR N
Practice Address - Street 2:APARTMENT # 334
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-2448
Practice Address - Country:US
Practice Address - Phone:267-980-8714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-02
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN527229L163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology