Nina Marie Shank, CRNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

SP018840 Issued in PA

Practice address

1100 E Northampton St
Laurel Run, PA 18706-9520

Phone

(570) 823-1171

NPI assigned

Aug 14, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wilkes Barre Treatment LLC

  • Substance Abuse Rehabilitation Facility
  • Laurel Run, PA
  • NPI 1740780279
  NPD
• Clear Brook, Inc.

  • Substance Abuse Rehabilitation Facility
  • Laurel Run, PA
  • NPI 1134235757
  NPD (past)
• Pennsylvania Care, LLC

  • Methadone Clinic
  • Ashley, PA
  • NPI 1467759399
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1699254201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 S MAIN ST",
            "city": "ASHLEY",
            "state": "PA",
            "postal_code": "187061506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E NORTHAMPTON ST",
            "city": "LAUREL RUN",
            "state": "PA",
            "postal_code": "187069520",
            "telephone_number": "570-823-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "NINA",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP018840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clear Brook, Inc.
• Sara Walkowiak
• Wilkes Barre Treatment LLC

• Primary Care Nurse Practitioner in Laurel Run, PA
• Providers in Laurel Run, PA by specialty
• Primary Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.