SHANE M HAFER (NPI# 1629611488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629611488 |
| Entity Type | Individual |
| Full Name | SHANE M HAFER |
| Credential | CRNP |
| Practice Address |
3600 Civic Center Blvd Fl 3 Philadelphia PA 19104-4310 |
| Mailing Address |
1017 Beech St Reading PA 19605-1405 |
| Practice Telephone | 2156626187 |
| Mailing Telephone | 4845297443 |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2019-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
SP020954 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3600 CIVIC CENTER BLVD FL 3 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496575 | Albert Abbo | Nurse Practitioner | 801 Spruce St Fl 3, Philadelphia, PA 19107-5701 | 2020-10-30 |
| 1902411721 | Sean Arthur Deiter | Nurse Practitioner | 3619 Gypsy Ln, Philadelphia, PA 19129-1612 | 2020-09-09 |
| 1972117687 | Christopher Brian Cox | Nurse Practitioner | 4527 Kingsessing Ave Fl 1, Philadelphia, PA 19143-3712 | 2020-09-01 |
| 1053949081 | Anna Sorci | Nurse Practitioner | 5401 Old York Rd # Klein300, Philadelphia, PA 19141-3030 | 2020-03-27 |
| 1184272262 | Judy Linh | Nurse Practitioner | 901 Glenview St, Philadelphia, PA 19111-4420 | 2019-08-31 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1942777909 | Jessica Lynn Goins | Nurse Practitioner | 111 S 11th St Bldg 934, Philadelphia, PA 19107-4824 | 2018-10-29 |
| 1891201968 | Stefanie Rashti | Nurse Practitioner | 1015 Walnut St Ste 401, Philadelphia, PA 19107-5005 | 2017-12-27 |
| 1780074336 | Bridget Gibson | Nurse Practitioner | 1522 E Susquehanna Ave, Philadelphia, PA 19125-2921 | 2015-02-03 |
| 1700295912 | Ellen Santella | Nurse Practitioner | 230 W Washington Sq Fl 3, Farm Journal Building, Philadelphia, PA 19106-3500 | 2014-08-13 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on SHANE M HAFER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.