Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Holly Shadle

Individual provider Family Nurse Practitioner · NPI 1235631490

Holly Shadle is a Nurse Practitioner in Williamsport, Pennsylvania. Qualified in 2017, 9 years ago. Practices with Phoenix Rehabilitation and Health Services Inc, a 2,720-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
9
Licensed in
PA
In the registry since
2018
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Practice location Address checks out

740 High St Ste 3002
Williamsport, PA 17701-3102
Phone: (570) 321-2820
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence SP018629 (PA)

Record details

NPI number1235631490
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 5, 2018
Last updated in NPPESFebruary 7, 2022
Certification dateFebruary 7, 2022
Mailing address1201 Grampian Blvd, Williamsport, PA 17701-1900

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Phoenix Rehabilitation And Health Services Inc — 2720 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Williamsport