Provider Demographics
NPI:1831497288
Name:SCHAFFER, CAROL (NP-C)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:SCHAFFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:1003 CAMINO RANCHITOS NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-1829
Mailing Address - Country:US
Mailing Address - Phone:267-307-4577
Mailing Address - Fax:505-200-0690
Practice Address - Street 1:1003 CAMINO RANCHITOS NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-1829
Practice Address - Country:US
Practice Address - Phone:267-307-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011254363LF0000X
NMCNP01750363LF0000X
TXAP120383363LP2300X
COC-APN.0002817-C-NP363LP2300X
NMCNP-01750363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM68151071Medicaid