Provider Demographics
NPI:1942878848
Name:SHIELDS, AMBER LEA (PA-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEA
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5375 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9666
Mailing Address - Country:US
Mailing Address - Phone:724-449-6245
Mailing Address - Fax:724-449-3233
Practice Address - Street 1:5375 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9666
Practice Address - Country:US
Practice Address - Phone:724-449-6245
Practice Address - Fax:724-449-3233
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA042183363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical