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Contact Information

SHELLEY ANN N PENNYCOOKE
1000 E MOUNTAIN DR
WILKES-BARRE, PA18711-0027
 Phone: 570-808-7762
 Fax: 570-808-6128
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SHELLEY ANN N PENNYCOOKE · (Female)

NPI # 1821297938
Status Active
Credentials
Entity Individual
Enumeration date 07/18/2007
Last updated 11/05/2025 - About 7 months ago
Sole proprietor 1 Yes
Identifiers
  • PA License # OS024274
  • NJ Medicaid 0181943
  • NJ Other P00766006 RR MEDICARE
Hospital affiliation(s)
  • RIVERVIEW MEDICAL CENTER - (Acute Care)
    ONE RIVERVIEW PLAZA
    RED BANK, NJ 07701
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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