Provider Demographics
NPI:1467742791
Name:SHAFFER, NANCY L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:L
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4828 COUNTY HIGHWAY 96
Mailing Address - Street 2:
Mailing Address - City:CAREY
Mailing Address - State:OH
Mailing Address - Zip Code:43316-9567
Mailing Address - Country:US
Mailing Address - Phone:419-396-6842
Mailing Address - Fax:
Practice Address - Street 1:429 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:UPPER SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:43351-1038
Practice Address - Country:US
Practice Address - Phone:419-294-3469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-12262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist