Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP024249 | PA |
NPI | 1154075703 |
---|---|
Provider Name | Shannon Elizabeth Dilger |
First Address | Temple, PA 19560-1957 |
Second Address | Bethlehem, PA 18015-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2022 |
Last Update Date | 11/02/2022 |