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General NPI Number Information
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NPI Number | 1497546303
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Entity Type | Individual
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Provider Name | OPAL MICHELLE SHAFFER RN
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 4424 E FLAMINGO AVE STE 300
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City | NAMPA
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State | ID
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Zip | 83687-9306
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Country | US
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Telephone | 208-302-0200
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Fax | 208-302-0255
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Provider Business Mailing Address
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Address Line | PO BOX 190930
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City | BOISE
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State | ID
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Zip | 83719-0930
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Country | US
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Telephone | 208-367-5170
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Fax | 208-367-5180
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 67521
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3071387
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 201605546RN
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License Number State | OR
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