Healthcare Provider Details

I. General information

NPI: 1043156185
Provider Name (Legal Business Name): HANNAH SHAFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 YOUNGSTOWN POLAND RD
STRUTHERS OH
44471-1103
US

IV. Provider business mailing address

1620 MUD BRIDGE RD
ENON VALLEY PA
16120-2706
US

V. Phone/Fax

Practice location:
  • Phone: 330-318-3078
  • Fax:
Mailing address:
  • Phone: 330-318-3078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0042057
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: