Provider Demographics
NPI:1740550169
Name:SHAFFER, DONNA L (NP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:SHAFFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:105 E UWCHLAN AVE
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1206
Mailing Address - Country:US
Mailing Address - Phone:302-245-3636
Mailing Address - Fax:
Practice Address - Street 1:105 E UWCHLAN AVE
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1206
Practice Address - Country:US
Practice Address - Phone:302-245-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000118363LF0000X
DCRN1006293363LF0000X
MDAC000296363LF0000X
PASP013366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily