Individual
ADRIAN LORAINE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
3372 W STEWARTS MILL RD, DOUGLASVILLE, GA 30135-2461
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN0030012469
GEORGIA NURSE AIDE REGISTRY
GA
Enumeration date
08/18/2014
Last updated
08/18/2014
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