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Individual

MISS COURTNEY NICOLE SHAFFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1907 W SYCAMORE ST # 200, KOKOMO, IN 46901-5148
(765) 236-8170
Mailing address
1907 W SYCAMORE ST # 200, KOKOMO, IN 46901-5148

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10002483A
IN

Other

Enumeration date
06/21/2018
Last updated
08/09/2024
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