Basic Information
Provider Information | |||||||||
NPI: | 1295140010 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SHIFFLER | ||||||||
FirstName: | APRYL | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | CRNP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1070 OLD NATIONAL PIKE | ||||||||
Address2: |   | ||||||||
City: | FREDERICKTOWN | ||||||||
State: | PA | ||||||||
PostalCode: | 153332114 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7246326801 | ||||||||
FaxNumber: | 7246326312 | ||||||||
Practice Location | |||||||||
Address1: | 1070 OLD NATIONAL PIKE | ||||||||
Address2: |   | ||||||||
City: | FREDERICKTOWN | ||||||||
State: | PA | ||||||||
PostalCode: | 153332114 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7246326801 | ||||||||
FaxNumber: | 7246326312 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/01/2014 | ||||||||
LastUpdateDate: | 07/01/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | SP013846 | PA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
ID | Type | State | Issuer | Description | 391812 | 01 | PA | UNITED GOVERNMENT SERVICES | OTHER | 014582 | 01 |   | HIGHMARK | OTHER | 1007288440027 | 05 | PA |   | MEDICAID | 391902 | 01 | PA | NATIONAL GOVERNMENT SERVICES | OTHER | 1007288440104 | 05 | PA |   | MEDICAID |