Individual provider · Type 1 NPI

Shannon Marie Nicosia, FNP

Nurse Practitioner · State College, PA

NPI number 1114539269 Active

Practice location

270 Walker Dr Ste 314E
State College, PA 16801-7097

Call (406) 840-0400 Map

Other practice locations

  • 233 E Main St, Bozeman, MT 59715-4977 · (986) 206-0414

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000X346354 (NY)
Nurse Practitioner Primary 363L00000XSP025407 (PA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1114539269

Shannon Marie Nicosia, FNP's National Provider Identifier is 1114539269, issued on Aug 20, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in State College, PA. The record was last updated on Oct 7, 2026.