Healthcare Provider Details

I. General information

NPI: 1881009454
Provider Name (Legal Business Name): JENNIFER JANET MAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JENNIFER JANET SHAFFER

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 11/26/2021
Certification Date: 11/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GRAMPIAN BLVD
WILLIAMSPORT PA
17701-1909
US

IV. Provider business mailing address

707 HADDONFIELD BERLIN RD
VOORHEES NJ
08043-3714
US

V. Phone/Fax

Practice location:
  • Phone: 570-320-7525
  • Fax: 570-320-7484
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMAO57260
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA003322
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00602600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: