| Doctor Name: | SANDRA SWISHER SHAVER |
| NPI Number: | 1073760377 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | F0608440 |
| Business Practice Address: | 305 E Lee Ave Yadkinville, NC - 270558132 |
| Business Phone Number: | 3366792661 |
| Business Fax Number: | 3366797056 |
| Mailing Address: | Po Box 751803, CHARLOTTE |
| State: | NC |
| Postal Code: | 282751803 |
| Phone Number: | 3366792661 |
| Fax Number: | 3366797056 |
| NPI Enumeration Date: | 08/19/2008 |
| NPI Last Update Date: | 07/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F0608440 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |