Provider Demographics
NPI:1346962909
Name:KECZAN, LINDSEY SHAFFER (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:SHAFFER
Last Name:KECZAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:LINDSEY
Other - Middle Name:MARIE
Other - Last Name:SHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2240 ARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-8707
Mailing Address - Country:US
Mailing Address - Phone:304-887-4994
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:PHYSICIANS OFFICE CENTER, 5TH FLOOR
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-598-6127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV86274163W00000X
WV114186363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse