Provider Demographics
NPI:1649970898
Name:SHAFFER, CINDY J (RN)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:J
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 30TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5753
Mailing Address - Country:US
Mailing Address - Phone:515-699-5550
Mailing Address - Fax:515-699-5710
Practice Address - Street 1:200 NE JACOB ST
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-2003
Practice Address - Country:US
Practice Address - Phone:515-699-5550
Practice Address - Fax:515-699-5710
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA116236163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management