Provider Demographics
NPI:1063258440
Name:WITT, SHAWNA LEIGH (PMHNP-BC, DNP)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:LEIGH
Last Name:WITT
Suffix:
Gender:
Credentials:PMHNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OLD POND RD STE 107
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1269
Mailing Address - Country:US
Mailing Address - Phone:412-319-7866
Mailing Address - Fax:412-914-8635
Practice Address - Street 1:200 OLD POND RD STE 107
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1269
Practice Address - Country:US
Practice Address - Phone:412-319-7866
Practice Address - Fax:412-914-8635
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN746469163W00000X
PASP029980363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse