Provider Demographics
NPI:1255518411
Name:WINTER-SCAVICCHIO, SHARON A (CRNP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:A
Last Name:WINTER-SCAVICCHIO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:A
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:CHMG GLEN MILLS FAMILY MEDICINE
Mailing Address - Street 2:300 EVERGREEN DR STE 150
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342
Mailing Address - Country:US
Mailing Address - Phone:610-579-3444
Mailing Address - Fax:610-579-3449
Practice Address - Street 1:CHMG GLEN MILLS FAMILY MEDICINE
Practice Address - Street 2:300 EVERGREEN DR STE 150
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342
Practice Address - Country:US
Practice Address - Phone:610-579-3444
Practice Address - Fax:610-579-3449
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily