Individual
ERICA J SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13535 NEMOURS PKWY, NEMOURS CHILDRENS HOSPITAL, ORLANDO, FL 32827-7402
(407) 567-4000
(407) 567-5924
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9252350
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005973500
—
FL
01
—
PENDING
BCBS
FL
Enumeration date
06/05/2012
Last updated
02/07/2017
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