Provider Demographics
NPI:1780254680
Name:SHAMUS, LEONARD (NP)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:SHAMUS
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6797
Mailing Address - Country:US
Mailing Address - Phone:814-231-7000
Mailing Address - Fax:814-231-7098
Practice Address - Street 1:1850 E PARK AVE STE 201
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6706
Practice Address - Country:US
Practice Address - Phone:814-231-7888
Practice Address - Fax:814-466-7489
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023931363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care