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Individual

SHERIDAN SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, NP-C

Contact information

Practice address
4740 N PENNGROVE WAY STE 100, MERIDIAN, ID 83646-7446
(208) 938-3663
Mailing address
4740 N PENNGROVE WAY STE 100, MERIDIAN, ID 83646-7446
(208) 938-3663

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4371061
ID

Other

Enumeration date
06/09/2025
Last updated
06/09/2025
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