Individual
ETHAN JOHN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
438 STUDENT HEALTH CTR, UNIVERSITY PARK, PA 16802-2129
(814) 863-0774
Mailing address
413 ARC RD, WEST DECATUR, PA 16878-8540
(814) 592-8509
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN271630
PA
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us