Doctor Name: | JENNIFER SHUHERK SHAFFER |
NPI Number: | 1831358597 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 11013246A |
Business Practice Address: | 11104 Parkview Circle Dr Suite 410 Fort Wayne, IN - 468451730 |
Business Phone Number: | 2602665260 |
Business Fax Number: | 2602665269 |
Mailing Address: | 1234 E Dupont Rd, Ste 1 FORT WAYNE |
State: | IN |
Postal Code: | 468251545 |
Phone Number: | 2603739728 |
Fax Number: | 2604585664 |
NPI Enumeration Date: | 06/06/2008 |
NPI Last Update Date: | 10/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 11013246A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |