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General NPI Number Information
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NPI Number | 1790260875
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Entity Type | Individual
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Provider Name | ANGIE SHAFFNER FNP
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Gender | Female
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 3409 CALLOWAY DR
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City | BAKERSFIELD
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State | CA
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Zip | 93312-2528
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Country | US
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Telephone | 800-300-6664
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Fax |
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Provider Business Mailing Address
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Address Line | 6707 CALLIE DR
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City | BAKERSFIELD
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State | CA
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Zip | 93308-3980
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F09180448
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License Number State | CA
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