Individual
LISA M SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-3138
Mailing address
5719 WOOD MOUSE CT, BURKE, VA 22015-2736
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001227095
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
084700
VA
Other
Enumeration date
03/23/2010
Last updated
02/05/2014
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