Provider Demographics
NPI:1922066877
Name:SHIMMEL, KRYSTAN N (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KRYSTAN
Middle Name:N
Last Name:SHIMMEL
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:100 RADNOR RD
Mailing Address - Street 2:STE 101
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7986
Mailing Address - Country:US
Mailing Address - Phone:814-231-7878
Mailing Address - Fax:814-237-1034
Practice Address - Street 1:100 RADNOR RD
Practice Address - Street 2:STE 101
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7986
Practice Address - Country:US
Practice Address - Phone:814-231-7878
Practice Address - Fax:814-237-1034
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2016-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOA000903363A00000X
PAMA051414363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant