Individual
MRS. CARLA KAE SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
780 S WILEY ST, CRESTLINE, OH 44827-1762
(419) 566-6112
Mailing address
780 S WILEY ST, CRESTLINE, OH 44827-1762
(419) 566-6112
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN105740
OH
Other
Enumeration date
07/20/2010
Last updated
07/20/2010
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