Provider Demographics
NPI:1922662022
Name:PANELLA, SHAWN ANTHONY (CRNP)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:ANTHONY
Last Name:PANELLA
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 OLD PITTSBURGH RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-6094
Mailing Address - Country:US
Mailing Address - Phone:724-698-3813
Mailing Address - Fax:781-209-4627
Practice Address - Street 1:2602 WILMINGTON RD STE 200
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1538
Practice Address - Country:US
Practice Address - Phone:724-657-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily