Provider Demographics
NPI:1497627566
Name:PENN STATE HEALTH
Entity type:Organization
Organization Name:PENN STATE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:SHEALYN
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:TROSTLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:717-306-8779
Mailing Address - Street 1:3903 DAISY DR
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-2227
Mailing Address - Country:US
Mailing Address - Phone:717-306-8779
Mailing Address - Fax:
Practice Address - Street 1:2200 GOOD HOPE RD
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1210
Practice Address - Country:US
Practice Address - Phone:717-306-8779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty