Individual
MILDRED ALEXANDRA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(252) 305-4900
Mailing address
5301 WILLOW RIDGE DR, SUMMERFIELD, NC 27358-7814
(252) 305-4900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
247109
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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