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

Shannon Lee Rakitis, CRNP

Individual provider Nurse Practitioner · NPI 1508751264

Shannon Lee Rakitis, CRNP is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2024, 2 years ago. Licensed in Pennsylvania.

Years since qualifying
2
Licensed in
PA
In the registry since
2025
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone: (215) 662-3487
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence SP032917 (PA)

Record details

NPI number1508751264
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedJune 11, 2025
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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