# JORDAN ANTHONY SHAW

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1982187274
- **Gender:** Man
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC0200X | Critical Care Medicine Registered Nurse | 14-140762-091 | KS | — |
| 363LA2100X | Acute Care Nurse Practitioner | 53-78418 | KS | Yes |

## Other

- **Enumeration date:** 09/12/2018
- **Last updated:** 02/21/2025