Provider Demographics
NPI:1720623523
Name:SHINGLER, COURTNEY (CRNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SHINGLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:MACKRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:241 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:MESHOPPEN
Mailing Address - State:PA
Mailing Address - Zip Code:18630-8013
Mailing Address - Country:US
Mailing Address - Phone:570-604-2848
Mailing Address - Fax:
Practice Address - Street 1:5950 SR 6
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-7905
Practice Address - Country:US
Practice Address - Phone:570-836-4294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020605363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily