Shaffer, Jennifer
Shaffer, Jennifer is an sole proprietor health care provider with primary practice located at 11104 Parkview Circle Dr Suite 410, Fort Wayne IN 46845-1730. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Shaffer, Jennifer can be contacted via phone (260) 266-5260.Contact Information
Primary practice address
11104 Parkview Circle Dr Suite 410
Fort Wayne IN 46845-1730
Phone: (260) 266-5260
Fax: (260) 266-5269
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 11013246A | Indiana |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 01071493 | Indiana |
Profile Details
| NPI number | 1831358597 |
|---|---|
| LBN Legal business name | Shaffer, Jennifer |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 6th, 2008 |
| Last updated | Oct 20th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831358597 | NPPES |
| Indiana | MEDICAID | 201083490 | |
| Indiana | Other | 000000775494 | |
| Indiana | Other | 0000005503 |
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