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Individual

VIRGINIA H. SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, NP

Contact information

Practice address
533 E COUNTY LINE RD, SUITE 102, GREENWOOD, IN 46143-1073
(317) 497-6626
(317) 887-4691
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
71000294
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201085890
IN
01
P01588259
RR MEDICARE
IN
Enumeration date
06/22/2006
Last updated
03/14/2016
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