Provider Demographics
NPI:1821292277
Name:SCHAEFFER, JENNIFER A (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40819 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-8914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9900 BREN RD E
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9664
Practice Address - Country:US
Practice Address - Phone:602-291-7794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO187975363LF0000X
IAA116866363LF0000X
AZ3749363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5550830009OtherMEDICARE NSC AZ NORTH
AZ5550830004OtherMEDICARE NSC PV
AZ5550830001OtherMEDICARE NSC SCW
AZ5550830008OtherMEDICARE NSC SWV
AZ5550830010OtherMEDICARE NSC GILBERT
AZ506835Medicaid
AZ5550830003OtherMEDICARE NSC PEORIA
AZ5550830006OtherMEDICARE NSC ANTHEM
AZ5550830007OtherMEDICARE NSC DV
AZ5550830008OtherMEDICARE NSC SWV