Doctor Name: | MR. BRIAN D SHIPTOSKI |
NPI Number: | 1861826430 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CRNP |
License Number: | SP008449 |
Business Practice Address: | 6454 Rt 405 Hwy Sci-muncy Muncy, PA - 17756 |
Business Phone Number: | 5705463171 |
Business Fax Number: | |
Mailing Address: | Po Box 180, Sci-muncy MUNCY |
State: | PA |
Postal Code: | 17756 |
Phone Number: | 5705463171 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2013 |
NPI Last Update Date: | 08/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP008449 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |