Individual
SHARON MELISSA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
72 PEACEFUL VALLEY DR, CLEVELAND, GA 30528-4247
(678) 313-1023
Mailing address
PO BOX 2031, CLEVELAND, GA 30528-0037
(678) 313-1023
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
RN249693
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN249693
GA
363LP2300X
Primary Care Nurse Practitioner
RN249693
GA
Other
Enumeration date
07/10/2021
Last updated
07/10/2021
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