Provider Demographics
NPI:1881733319
Name:SHUCAVAGE, MEGAN (CRNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SHUCAVAGE
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 1:1241 BLAKESLEE BOULEVARD DR E STE 3
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-2401
Mailing Address - Country:US
Mailing Address - Phone:570-645-1020
Mailing Address - Fax:570-645-1021
Practice Address - Street 1:1241 BLAKESLEE BOULEVARD DR E STE 3
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-2401
Practice Address - Country:US
Practice Address - Phone:570-645-1020
Practice Address - Fax:570-645-1021
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008661363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1995717OtherHIGHMARK BLUE SHIELD
50085666OtherCAPITAL BLUE CROSS
PA118832EU8Medicare PIN
PA118832Medicare PIN