Healthcare Provider Details

I. General information

NPI: 1740550169
Provider Name (Legal Business Name): DONNA L. SHAFFER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DONNA SHAFFER NP

II. Dates (important events)

Enumeration Date: 01/02/2012
Last Update Date: 12/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E UWCHLAN AVE
EXTON PA
19341-1206
US

IV. Provider business mailing address

105 E UWCHLAN AVE
EXTON PA
19341-1206
US

V. Phone/Fax

Practice location:
  • Phone: 302-245-3636
  • Fax:
Mailing address:
  • Phone: 302-245-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG0000118
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1006293
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC000296
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013366
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: