Provider Demographics
NPI:1043583040
Name:SCHOFFNER, SUSAN SHALANE (RNC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:SHALANE
Last Name:SCHOFFNER
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:SHALANE
Other - Last Name:SCHOFFNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:15747 BELAIRE PL
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895
Mailing Address - Country:US
Mailing Address - Phone:419-230-8047
Mailing Address - Fax:
Practice Address - Street 1:15747 BELAIRE PL
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-9489
Practice Address - Country:US
Practice Address - Phone:419-230-8047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH324088163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse