Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 0029088 | OH |
NPI | 1134797012 |
---|---|
Provider Name | Veronica Rae Shaffer |
First Address | New Castle, PA 16105-2904 |
Second Address | Boardman, OH 44512-6725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2021 |
Last Update Date | 16/06/2021 |