Individual
MS. MARY J SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
722 S WAHSATCH AVE, COLORADO SPRINGS, CO 80903-4035
(719) 632-5700
(719) 344-7828
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5101
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
63257
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01771582
—
CO
Enumeration date
12/20/2006
Last updated
04/05/2017
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