Provider Demographics
NPI:1639634405
Name:SHINNEMAN, AMY B (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:SHINNEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:B
Other - Last Name:KAMERER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 HILLTOP PLZ
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-8905
Mailing Address - Country:US
Mailing Address - Phone:724-545-8420
Mailing Address - Fax:724-545-7426
Practice Address - Street 1:11 HILLTOP PLZ
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-8905
Practice Address - Country:US
Practice Address - Phone:724-545-8420
Practice Address - Fax:724-545-7426
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN619044163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse