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NPI Code Detail

MEDICARE: MRS. CYNTHIA FERNANDEZ SHAFFER NP-C

MEDICARE: MRS. CYNTHIA FERNANDEZ SHAFFER NP-C
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
1207QA0505XAdult Medicine PhysicianAPN5567TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15567OTHERTNAPN LICENSE

General Provider Information

NPI Number : 1891798047
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA FERNANDEZ SHAFFER NP-C
Provider Business Mailing Address
First Line : PO BOX 891
Second Line :
City : COLLEGEDALE
State : TN
Zip : 37315-0891
Country : US
Telephone Number : 423-778-9701
Fax Number :
Provider Business Practice Location Address
First Line : 9309 APISON PIKE
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-4340
Country : US
Telephone Number : 423-778-9701
Fax Number : 423-778-9713
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 02/20/2014

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