Provider Demographics
NPI:1134472665
Name:SHUFFORD, KARINE
Entity Type:Individual
Prefix:
First Name:KARINE
Middle Name:
Last Name:SHUFFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 RIPTIDE CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-2044
Mailing Address - Country:US
Mailing Address - Phone:817-987-7209
Mailing Address - Fax:
Practice Address - Street 1:4505 RIPTIDE CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-2044
Practice Address - Country:US
Practice Address - Phone:817-987-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion