Individual
JENNIFER SMITH SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
275995-4405
UT
363LA2200X
Adult Health Nurse Practitioner
Primary
275995-4405
UT
363LG0600X
Gerontology Nurse Practitioner
275995-4405
UT
363LP2300X
Primary Care Nurse Practitioner
275995-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
275995-4405
UTAH APRN LICENSE
UT
Enumeration date
10/10/2013
Last updated
10/21/2021
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