Provider Demographics
NPI:1194563643
Name:AGNES SCHAFFER
Entity type:Organization
Organization Name:AGNES SCHAFFER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN LACTATION CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, IBCLC
Authorized Official - Phone:815-342-9154
Mailing Address - Street 1:11925 LUNA DEL MAR LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-4526
Mailing Address - Country:US
Mailing Address - Phone:815-342-9154
Mailing Address - Fax:
Practice Address - Street 1:9280 W SUNSET RD STE 400
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4862
Practice Address - Country:US
Practice Address - Phone:725-900-8613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty