Individual
JUDY-LYNN SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
491 GOLD STAR HWY, GROTON, CT 06340
(860) 445-5107
(860) 448-1368
Mailing address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-2485
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
002332
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004209260
—
CT
Enumeration date
09/06/2006
Last updated
04/08/2020
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