Provider Demographics
NPI:1861489767
Name:MONAHAN, SHARON R (CRNA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:R
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN261613L163W00000X
PA048965367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027798150001Medicaid
PA11776582OtherCAQH
PA03224401OtherCAPITAL ADVANTAGE
PA9716477OtherAETNA
PA2036414000OtherINDEP. BLUE CROSS
PA1543371OtherGATEWAY
PA1343802OtherHIGHMARK
PA1343802OtherFIRST PRIORITY
PA73270OtherGEISINGER
PA1343802OtherKHPCENTRAL
PA1027798150001Medicaid
PA03224401OtherCAPITAL ADVANTAGE
PA008069QCYMedicare PIN