Provider Demographics
NPI:1780651364
Name:TERENCHIN, SHIRLEY B (CRNP)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:B
Last Name:TERENCHIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:BUCHER-LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:562 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-1816
Mailing Address - Country:US
Mailing Address - Phone:717-626-2167
Mailing Address - Fax:717-626-1915
Practice Address - Street 1:562 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-1816
Practice Address - Country:US
Practice Address - Phone:717-626-2167
Practice Address - Fax:717-626-1915
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP000778B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50052503OtherCAPITAL BLUE CROSS
PAS62056OtherHEALTH ASSURANCE
PA50052503OtherCAPITAL BLUE CROSS
PAS62056OtherHEALTH ASSURANCE