Basic Information
| Provider Information | |||||||||
| NPI: | 1194335091 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAHEEN | ||||||||
| FirstName: | ASHLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 408 ASHBROOK CIR | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | EBENSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159314354 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 620 HOWARD AVE | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | ALTOONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166014804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148892011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2020 | ||||||||
| LastUpdateDate: | 05/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | MA061559 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.