Provider Demographics
NPI:1801861174
Name:SHAFER, DAWN CHRISTINE (RN-CFNP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:CHRISTINE
Last Name:SHAFER
Suffix:
Gender:F
Credentials:RN-CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 W 7TH AVE
Mailing Address - Street 2:PO BOX 426
Mailing Address - City:FLOODWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55736-0426
Mailing Address - Country:US
Mailing Address - Phone:218-476-2221
Mailing Address - Fax:218-476-2965
Practice Address - Street 1:126 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:FLOODWOOD
Practice Address - State:MN
Practice Address - Zip Code:55736-0426
Practice Address - Country:US
Practice Address - Phone:218-476-2221
Practice Address - Fax:218-476-2965
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR068631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FM51G11OtherMPIN
S21470Medicare UPIN