Individual
CHARISSE F SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13100 E 136TH ST STE 2400, FISHERS, IN 46037-9810
(317) 678-3777
Mailing address
13100 E 136TH ST STE 2400, FISHERS, IN 46037-9810
(317) 678-3777
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71016010A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104854013
ANTHEM PTAN
IN
Enumeration date
01/13/2025
Last updated
03/04/2025
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