Individual
KAITLIN WICKERSHAM-SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 753-7541
Mailing address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71012651A
IN
Other
Enumeration date
06/16/2022
Last updated
03/31/2025
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