Shaver, Jeannelle M

Shaver, Jeannelle M is an individual health care provider with primary practice located at 102 Park Street Pryun Pavilioin At Glens Falls Hospital The Vascular Group Pllc, Glens Falls NY 12801. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Shaver, Jeannelle M can be contacted via phone (518) 792-7122.

Contact Information

Primary practice address
102 Park Street Pryun Pavilioin At Glens Falls Hospital The Vascular Group Pllc Glens Falls NY 12801
Phone: (518) 792-7122
Fax: (518) 792-3800
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 007337 New York

Profile Details

NPI number 1225007347
LBN Legal business name Shaver, Jeannelle M
Credentials RPA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225007347 NPPES
New York MEDICAID 02341202

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