Provider Demographics
NPI:1184611147
Name:NACHESTY, SHARON M (CRNA)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:NACHESTY
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 1:400 N 17TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5052
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN163413L163W00000X
PA018111367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1338091OtherFIRST PRIORITY
PA1546370OtherGATEWAY
PA77514OtherGEISINGER
PA9958456OtherAETNA
PA02272902OtherCAPITAL ADVANTAGE
PA11776585OtherCAQH
PA1338091OtherHIGHMARK
PA1338091OtherKHP CENTRAL
PA2030884000OtherINDEP. BLUE CROSS
PA1027794770001Medicaid
PA1338091OtherFIRST PRIORITY
PA9958456OtherAETNA
PA005448QCYMedicare PIN