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Individual

ANTHONY JAMES SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
7190 W FLEETWOOD LN, GLENDALE, AZ 85303-7606
(602) 568-8381
Mailing address
7190 W FLEETWOOD LN, GLENDALE, AZ 85303-7606
(602) 568-8381

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
221810
AZ
363LA2200X
Adult Health Nurse Practitioner
221810
AZ
363LG0600X
Gerontology Nurse Practitioner
221810
AZ

Other

Enumeration date
01/30/2019
Last updated
01/30/2019
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