Individual
JAIME DEANA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN FNP-BC
Contact information
Practice address
417 SABBATH REST RD STE 3, ALTOONA, PA 16601-7567
(814) 940-8195
(814) 940-8816
Mailing address
267 JACKS WAY, DUNCANSVILLE, PA 16635-7217
(814) 312-4256
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP025903
PA
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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