Individual
ANGELA L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
17609 OLD JEFFERSON HWY STE A, PRAIRIEVILLE, LA 70769-3980
(225) 647-8511
(225) 743-2085
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 343-9505
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP05787
LA
363LP0200X
Pediatric Nurse Practitioner
RN107541
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1884910
—
LA
Enumeration date
03/23/2009
Last updated
01/21/2026
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