Provider Demographics
NPI:1598281305
Name:SHAFFER, CHRISTINA JO (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JO
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1220
Mailing Address - Country:US
Mailing Address - Phone:603-883-7970
Mailing Address - Fax:603-595-3652
Practice Address - Street 1:460 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1220
Practice Address - Country:US
Practice Address - Phone:603-883-7970
Practice Address - Fax:603-595-3652
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA6227363A00000X
NH1298363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant