Provider Demographics
NPI:1851758742
Name:SHAFFER, CHERYL (RN, BSN, MSN)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:RN, BSN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 WISHART PL
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-4410
Mailing Address - Country:US
Mailing Address - Phone:724-699-0255
Mailing Address - Fax:
Practice Address - Street 1:831 HARRISON ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-4870
Practice Address - Country:US
Practice Address - Phone:724-652-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN504968L163W00000X, 163WA2000X, 163WC0400X, 163WC1500X, 163WD0400X, 163WH0200X, 163WH1000X, 163WP0808X, 163WP0809X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No164W00000XNursing Service ProvidersLicensed Practical Nurse