Provider Demographics
NPI:1841906013
Name:SHAFFER, EMMA LYNN
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:LYNN
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1296 SLADE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4055
Mailing Address - Country:US
Mailing Address - Phone:614-483-2487
Mailing Address - Fax:
Practice Address - Street 1:1296 SLADE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4055
Practice Address - Country:US
Practice Address - Phone:614-483-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker