Individual
MS. MILDRED ELAINE SHAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0002
(309) 683-6740
(309) 683-6746
Mailing address
7918 W THORNRIDGE DR, MAPLETON, IL 61547-9347
(309) 683-6740
(309) 683-6746
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
209000900
IL
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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