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General NPI Number Information
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NPI Number | 1578039061
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Entity Type | Individual
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Provider Name | JACQUELINE A SHAFFER WHNP
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Gender | Female
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 4139 BOARDMAN CANFIELD RD STE 1
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City | CANFIELD
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State | OH
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Zip | 44406-9034
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Country | US
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Telephone | 330-702-1372
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Fax | 330-702-1287
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Provider Business Mailing Address
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Address Line | 100 DEBARTOLO PL STE 200
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-6095
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Country | US
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Telephone | 330-729-8145
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Fax | 330-965-5229
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APRN.CNP.023891
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License Number State | OH
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