Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | UP005961U | PA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | UP-005961-U | PA |
NPI | 1386626042 |
---|---|
Provider Name | Ms. Jill Boone Schaeffer |
First Address | Lancaster, PA 17603-2964 |
Second Address | Lancaster, PA 17603-2964 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 25/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S86971 | (02) |