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General NPI Number Information
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NPI Number | 1487971339
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Entity Type | Individual
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Provider Name | TRACEY LYNN SHAFFER R.D.
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Gender | Female
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Dates
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Enumeration Date | 04/30/2010
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 1014 VINE ST
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City | CINCINNATI
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State | OH
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Zip | 45202-1141
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Country | US
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Telephone | 855-699-6937
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 830242
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City | PHILADELPHIA
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State | PA
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Zip | 19182-0242
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Country | US
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Telephone | 615-425-4200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 10220695
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DX5577
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DI61281597
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT87459
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 09740
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2710
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License Number State | OK
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Taxonomy #7
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 6059-29
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License Number State | WI
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Taxonomy #8
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2007003698
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License Number State | MO
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