Shupp, Randi L.

Shupp, Randi L. is an individual health care provider with primary practice located at 250 Cetronia Road Suite 303, Allentown PA 18104-9168. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Shupp, Randi L. can be contacted via phone (610) 973-6200.

Contact Information

Primary practice address
250 Cetronia Road Suite 303 Allentown PA 18104-9168
Phone: (610) 973-6200
Fax: (610) 973-6546
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA051867 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X MA051867 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X MA051867 Pennsylvania

Profile Details

NPI number 1831183854
LBN Legal business name Shupp, Randi L.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2005
Last updated Dec 23rd, 2015 - about 9 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 1831183854 NPPES
Pennsylvania Other 50053681 BLUE CROSS
Pennsylvania Other 50053681 BLUE CROSS

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