Provider Demographics
NPI:1417765066
Name:WILLIAMS, SHAUNA PAIGE
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:PAIGE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:PAIGE
Other - Last Name:POLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2913 WHITEMARSH PL
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-1407
Mailing Address - Country:US
Mailing Address - Phone:610-999-1261
Mailing Address - Fax:
Practice Address - Street 1:2913 WHITEMARSH PL
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-1407
Practice Address - Country:US
Practice Address - Phone:610-999-1261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay