Provider Demographics
NPI:1588828503
Name:SCHAFFER, SANDRA K (APNP, FNP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:K
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:APNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 S KOELLER ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54902-6214
Mailing Address - Country:US
Mailing Address - Phone:920-223-7100
Mailing Address - Fax:920-223-7462
Practice Address - Street 1:1855 S KOELLER ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54902-6214
Practice Address - Country:US
Practice Address - Phone:920-223-7136
Practice Address - Fax:920-223-7462
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3459-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36090000Medicaid
WI062771018Medicare PIN