Provider Demographics
NPI:1164033205
Name:OLIVER, SHANNA (DNP, CRNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:DNP, CRNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-1040
Mailing Address - Country:US
Mailing Address - Phone:724-888-0246
Mailing Address - Fax:
Practice Address - Street 1:1230 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-1040
Practice Address - Country:US
Practice Address - Phone:724-888-0246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily