Provider Demographics
NPI:1811099039
Name:SHAEFFER, JAN LYNN (FNPC)
Entity type:Individual
Prefix:MS
First Name:JAN
Middle Name:LYNN
Last Name:SHAEFFER
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 CITRINE CV
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2272
Mailing Address - Country:US
Mailing Address - Phone:972-294-8421
Mailing Address - Fax:940-591-3211
Practice Address - Street 1:3980 STATE SCHOOL ROAD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210
Practice Address - Country:US
Practice Address - Phone:940-891-0342
Practice Address - Fax:940-591-3211
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX244018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS48362Medicare UPIN