Provider Demographics
NPI:1750361317
Name:MCNINCH, SHAREEN (CRNP)
Entity type:Individual
Prefix:
First Name:SHAREEN
Middle Name:
Last Name:MCNINCH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LEONARD AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-225-8364
Mailing Address - Fax:724-225-3093
Practice Address - Street 1:95 LEONARD AVE
Practice Address - Street 2:STE 300
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3368
Practice Address - Country:US
Practice Address - Phone:724-225-8364
Practice Address - Fax:724-225-3093
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP001798G363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA052632Medicare PIN
P43956Medicare UPIN