Individual
KRISTA L SHAW
Active
Individual
KRISTA L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCADC
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
CADC-29393
NC
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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