Provider Demographics
NPI:1770874125
Name:SHAFFER, MARGARET KAY (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:KAY
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:ST BENEDICT
Mailing Address - State:PA
Mailing Address - Zip Code:15773-0085
Mailing Address - Country:US
Mailing Address - Phone:814-496-9418
Mailing Address - Fax:
Practice Address - Street 1:204 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:CARROLLTOWN
Practice Address - State:PA
Practice Address - Zip Code:15722-7210
Practice Address - Country:US
Practice Address - Phone:814-458-1155
Practice Address - Fax:800-958-2475
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011071363L00000X, 363LF0000X
PASP024869363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2792391OtherHIGHMARK
PA269952 PLGMedicare PIN