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Individual

KIMBERLY GRACE SHAFFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C, CRNP

Contact information

Practice address
820 S WASHINGTON AVE, SCRANTON, PA 18505-1639
(570) 561-4472
Mailing address
127 ORCHARD DR, JEFFERSON TOWNSHIP, PA 18436-7708
(570) 561-4472

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F08220620
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
SP026314
PA

Other

Enumeration date
10/06/2022
Last updated
09/13/2024
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