Provider Demographics
NPI:1487768115
Name:SHEARER, DENISE LYNN (PAC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:LYNN
Last Name:SHEARER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 EAST BRADY STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001
Mailing Address - Country:US
Mailing Address - Phone:724-285-9200
Mailing Address - Fax:724-285-9288
Practice Address - Street 1:901 EAST BRADY STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001
Practice Address - Country:US
Practice Address - Phone:724-285-9200
Practice Address - Fax:724-285-9288
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA050689363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant