Individual
WHITNEY J. SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3909 NEW VISION DR, FORT WAYNE, IN 46845-1725
(260) 425-5500
(260) 425-5525
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71005021A
IN
363L00000X
Nurse Practitioner
APRN.CNP.0040834
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201254970
—
IN
Enumeration date
07/29/2014
Last updated
03/30/2026
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