Provider Demographics
NPI:1588499941
Name:SHAFFER, TAYLOR M (NP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:M
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:M
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:550 UNIVERSITY BLVD STE 6100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5149
Mailing Address - Country:US
Mailing Address - Phone:317-948-9899
Mailing Address - Fax:317-944-4319
Practice Address - Street 1:550 UNIVERSITY BLVD STE 6100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5149
Practice Address - Country:US
Practice Address - Phone:317-948-9899
Practice Address - Fax:317-944-4319
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015699A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily