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General NPI Number Information
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NPI Number | 1730775883
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Entity Type | Individual
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Provider Name | NIKKI M SHAFFER
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Gender | Female
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Dates
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Enumeration Date | 12/14/2020
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 700 PARK AVE
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City | IRONTON
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State | OH
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Zip | 45638-1502
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Country | US
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Telephone | 740-532-1613
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Fax | 740-879-0599
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Provider Business Mailing Address
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Address Line | 6400 E BROAD ST STE 400
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City | COLUMBUS
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State | OH
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Zip | 43213-2979
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Country | US
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Telephone | 614-655-3345
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Fax | 614-317-4689
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CDCA.175187
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CDCA.179160
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License Number State | OH
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