Provider Demographics
NPI:1699774653
Name:SHEDLOSKY, KRISTA ELLEN (RN)
Entity type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:ELLEN
Last Name:SHEDLOSKY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:312 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHIREMANSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17011-6332
Mailing Address - Country:US
Mailing Address - Phone:717-731-9241
Mailing Address - Fax:717-245-1938
Practice Address - Street 1:28 N COLLEGE AND LOUTHER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013
Practice Address - Country:US
Practice Address - Phone:717-245-1835
Practice Address - Fax:717-245-1938
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN187048L163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health