Individual
KRISTY DAWN SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1000 HEALTH CENTER DR STE 107, MATTOON, IL 61938-4644
(217) 258-4096
(217) 238-5485
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277-003062
IL
Other
Enumeration date
11/05/2018
Last updated
12/29/2025
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