Healthcare Provider Details

I. General information

NPI: 1215379441
Provider Name (Legal Business Name): RACHAYL LEIGH SHAFFER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24292 GRAYLEAF WILLOW PL
STONE RIDGE VA
20105-6048
US

IV. Provider business mailing address

24292 GRAYLEAF WILLOW PL
ALDIE VA
20105-6048
US

V. Phone/Fax

Practice location:
  • Phone: 609-744-5134
  • Fax:
Mailing address:
  • Phone: 609-744-5134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110004347
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: