Provider Demographics
NPI:1710657358
Name:SHEAFFER, JAMIE LYN (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYN
Last Name:SHEAFFER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8122 OSPREY ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2840
Mailing Address - Country:US
Mailing Address - Phone:231-670-2436
Mailing Address - Fax:
Practice Address - Street 1:8122 OSPREY ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2840
Practice Address - Country:US
Practice Address - Phone:231-670-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122057225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist