Individual
MS. STACEY LYNN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2423 HIGHWAY 17 S, NORTH MYRTLE BEACH, SC 29582-4343
(843) 919-0700
(843) 919-0727
Mailing address
286 JUNCO CIR, LONGS, SC 29568-6965
(843) 321-5099
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
20127
SC
Other
Enumeration date
10/20/2017
Last updated
09/25/2023
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