Provider Demographics
NPI:1285135459
Name:SHANK, CIARA (CNM)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:SHANK
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Mailing Address - Street 1:4700 UNION DEPOSIT RD STE 140
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3774
Mailing Address - Country:US
Mailing Address - Phone:717-652-6605
Mailing Address - Fax:717-652-6431
Practice Address - Street 1:4700 UNION DEPOSIT RD STE 140
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-3774
Practice Address - Country:US
Practice Address - Phone:717-652-6605
Practice Address - Fax:717-652-6431
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.019351176B00000X
PAMW010500367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife