Shafer, Natasha Charlyn

Shafer, Natasha Charlyn is an individual health care provider with primary practice located at 1340 Cedar Ct Ste 202 , Carbondale IL 62901. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Shafer, Natasha Charlyn can be contacted via phone (618) 529-7821.

Contact Information

Primary practice address
1340 Cedar Ct Ste 202 Carbondale IL 62901
Phone: (618) 529-7821
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2012006260 Missouri

Profile Details

NPI number 1023375409
LBN Legal business name Shafer, Natasha Charlyn
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2012
Last updated Sep 12th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023375409 NPPES
Illinois Other 209010067 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
Illinois Other 3903223660 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
Illinois Other 2012001998 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

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