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Individual

MS. GUADALUPE C. SHAFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
19305 RUBY DR., LEESBURG, VA 20176-3733
(703) 407-7204
Mailing address
19438 NEWTON PASS SQ, LEESBURG, VA 20176-6523
(703) 407-7204
(703) 407-7204

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024165767
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010199964
VA
05
010200504
VA
05
010200512
VA
05
010200563
VA
Enumeration date
06/27/2006
Last updated
01/28/2019
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