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NPI Code Detail

MEDICARE: STEPHANIE ANNE SHAFFER

MEDICARE: STEPHANIE ANNE SHAFFER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN.CNP.022524OH

General Provider Information

NPI Number : 1467956078
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ANNE SHAFFER
Provider Business Mailing Address
First Line : 4988 BAYCROFT DR
Second Line :
City : HILLIARD
State : OH
Zip : 43026-7108
Country : US
Telephone Number : 419-217-4833
Fax Number :
Provider Business Practice Location Address
First Line : 4656 CEMETERY RD
Second Line :
City : HILLIARD
State : OH
Zip : 43026-1298
Country : US
Telephone Number : 614-345-0237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2018
Last Update Date : 01/28/2019

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