CAROLINE CUCKLER SHANE (NPI# 1083194914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083194914 |
| Entity Type | Individual |
| Full Name | CAROLINE CUCKLER SHANE |
| Credential | CRNP |
| Practice Address |
4865 Market St Philadelphia PA 19139-3508 |
| Mailing Address |
6 Post Rd Malvern PA 19355-3509 |
| Practice Telephone | 2674259800 |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2018-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
SP018621 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4865 MARKET ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19139-3508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801895727 | Mary B. Kawan | Pediatrics | 4865 Market St, Philadelphia, PA 19139-3508 | 2005-07-21 |
| 1467084673 | Constance Joy Bienkowski | Counselor | 4865 Market St, Philadelphia, PA 19139-3508 | 2020-02-05 |
| 1053941708 | Hannah Brown | Counselor | 4865 Market St, Philadelphia, PA 19139-3508 | 2020-01-22 |
| 1316595069 | Caitlin Park-davidson | Counselor | 4865 Market St, Philadelphia, PA 19139-3508 | 2019-08-27 |
| 1578128229 | Carmelita Sharonique Foster | Psychologist | 4865 Market St, Philadelphia, PA 19139-3508 | 2019-05-08 |
| 1467921718 | Jessica Rose Clymer | Nurse Practitioner | 4865 Market St, Philadelphia, PA 19139-3508 | 2018-11-15 |
| 1225541691 | Evelyn Brooks Ridgeway | Psychologist | 4865 Market St, Philadelphia, PA 19139-3508 | 2017-11-08 |
| 1194235192 | Kelly Marie Hopton-jones | Nurse Practitioner | 4865 Market St, Philadelphia, PA 19139-3508 | 2017-10-04 |
| 1679980528 | The Children's Hospital of Philadlephia | Clinic/Center | 4865 Market St, Philadelphia, PA 19139-3508 | 2014-07-11 |
| 1922439884 | Amanda Sullivan | Nurse Practitioner | 4865 Market St, Philadelphia, PA 19139-2912 | 2013-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1770192890 | Michael Pappano LLC | Social Worker | 31 South 51st St, Philadelphia, PA 19139 | 2020-07-24 |
| 1912419581 | Christina Lipuma | Dietitian, Registered | 5210 Haverford Ave, Philadelphia, PA 19139 | 2017-11-03 |
| 1538515564 | New Vitae Inc | Public Health or Welfare | 27 S 55th Street, Philadelphia, PA 19139 | 2016-05-09 |
| 1982058681 | Phyllis Mwaura | In Home Supportive Care | 5338 Vine Street, Basement, Philadelphia, PA 19139 | 2016-04-19 |
| 1861879322 | Barbara Joette Hegarty | Counselor | 4508 Chestnut Street, Philadelphia, PA 19139 | 2015-05-04 |
| 1336533454 | Julie Magallanes-montone | Family Medicine | 5201 Haverford Avenue, Philadelphia, PA 19139 | 2015-03-26 |
| 1134494909 | The Children's Hospital of Philadelphia | Pediatrics | 4865 Market Street, Philadelphia, PA 19139 | 2012-03-13 |
| 1467757443 | Nouman Bashir | Dentist | 5139 Chestnut Stree, Philadelphia, PA 19139 | 2011-01-21 |
| 1720396732 | Serena Denise Johnson | Contractor | 5151a Walnut Street, Philadelphia, PA 19139 | 2010-09-24 |
| Find all providers in zip 19139 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584404 | Elizabeth Perry Hayes | Nurse Practitioner | 837 Wilder St, Philadelphia, PA 19147-5713 | 2020-10-06 |
| 1952919771 | Caitlin Wetzler | Nurse Practitioner | 2028 Rittenhouse Sq Apt 103, Philadelphia, PA 19103-5621 | 2020-07-17 |
| 1013476134 | Victoria Nicole Hudson | Nurse Practitioner | 7056 Germantown Ave Ste 102, Philadelphia, PA 19119-1826 | 2019-03-18 |
| 1700371978 | Kristi Ford | Nurse Practitioner | 160 E Erie Ave # 21542, Philadelphia, PA 19134 | 2018-06-28 |
| 1275026528 | Eileen Cawley Paynton | Nurse Practitioner | 7500 Central Ave Ste 205, Philadelphia, PA 19111-2432 | 2018-06-12 |
| 1811488091 | Lisa Jang | Nurse Practitioner | 3400 Civic Center Blvd Dept General, Philadelphia, PA 19104-5127 | 2018-05-23 |
| 1861999542 | Bashira Charles | Nurse Practitioner | 440 North Broad Street, Student Health Services, Philadelphia, PA 10130-4015 | 2018-04-10 |
| 1356883938 | Laura-therese Martone | Nurse Practitioner | 501 S 26th St Unit 1, Philadelphia, PA 19146-1008 | 2016-11-14 |
| 1578017042 | Education Plus, Inc. | Nurse Practitioner | 3217 W. Clearfield Street, Philadelphia, PA 19132 | 2016-08-12 |
| 1396194106 | Lisa Mcfarlane | Nurse Practitioner | 6340 Wayne Ave, Philadelphia, PA 19144-3113 | 2016-06-13 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19139 |
Please comment or provide details below to improve the information on CAROLINE CUCKLER SHANE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.