Individual
MRS. LAURA DE MAURIAC SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1411 W 7TH ST, STE 102, STILLWATER, OK 74074-4300
(405) 624-8222
(405) 372-3769
Mailing address
9212 BURR OAK ST, STILLWATER, OK 74074-8346
(405) 377-0418
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R0027775
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1727775
—
OK
Enumeration date
08/02/2005
Last updated
07/08/2007
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