Individual
BRADEN J SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
3871 E HIGHWAY 98 STE 203, PORT ST JOE, FL 32456-5302
(850) 229-5661
(850) 229-5662
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6014
(904) 450-6401
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209018862
IL
363LF0000X
Family Nurse Practitioner
Primary
APRN11004356
FL
Other
Enumeration date
02/25/2019
Last updated
02/15/2021
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