Provider Demographics
NPI:1013434760
Name:NASH, SHANNON MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARIE
Last Name:NASH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:FL 2
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:205-747-2710
Mailing Address - Fax:205-747-2712
Practice Address - Street 1:313 NEFF AVE STE C
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3495
Practice Address - Country:US
Practice Address - Phone:540-434-1200
Practice Address - Fax:540-434-1203
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH8595225100000X
OK5562225100000X
VA2305212728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist