MEDICARE: SHELBY SHAFFER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1005X	Renal Nutrition Registered Dietitian	803808	AZ

General Provider Information

NPI Number	:	1932033198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY SHAFFER

Provider Business Mailing Address
First Line	:	1780 W ANKLAM RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-2632
Country	:	US
Telephone Number	:	520-975-8700
Fax Number	:	800-449-1241

Provider Business Practice Location Address
First Line	:	1780 W ANKLAM RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-2632
Country	:	US
Telephone Number	:	520-975-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “ SHELBY SHAFFER ” Practice Location

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