Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | ||
Y | 363LF0000X | Nurse Practitioner - Family Medicine | SP009361 | PA |
NPI | 1023146693 |
---|---|
Provider Name | Dr. Lynn Ellen Shay |
First Address | Barto, PA 19504-8811 |
Second Address | Phoenixville, PA 19460-2676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/01/2019 |