| NPI | 1275147324 | 
|---|---|
| Former Name | KATELYN SHAFFER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 106784)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD ACOO3351)  | 
| Enumeration Date | 2020-09-05 | 
| Last Update Date | 2025-09-23 |