Individual
CRYSTAL SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1100 BELK BLVD, OXFORD, MS 38655-5242
(662) 636-5320
Mailing address
3042 COUNTY ROAD 85, COFFEEVILLE, MS 38922-3411
(662) 809-1619
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
896703
MS
363LF0000X
Family Nurse Practitioner
Primary
F09220871
MS
Other
Enumeration date
11/24/2020
Last updated
11/21/2022
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