Basic Information
| Provider Information | |||||||||
| NPI: | 1023027406 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAFFER | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | WHNP, CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 325 FOREST CT | ||||||||
| Address2: | |||||||||
| City: | MARTINEZ | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309079611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7066272099 | ||||||||
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| Practice Location | |||||||||
| Address1: | 710 CENTER ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319011527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065711000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 02/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | AP60119769 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 363LX0001X | RN069901 | GA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 367A00000X | RN069901 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | AP60119769 | 01 | WA | LICENSE | OTHER |