Provider Demographics
NPI:1215902945
Name:SHIELDS, LINDA J (CRNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:MICHALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5171 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2254
Mailing Address - Country:US
Mailing Address - Phone:412-683-4550
Mailing Address - Fax:412-246-4567
Practice Address - Street 1:2690 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2302
Practice Address - Country:US
Practice Address - Phone:412-683-4550
Practice Address - Fax:412-246-4567
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004872B363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA005781UARMedicare ID - Type Unspecified
PAS48622Medicare UPIN