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Individual

AMY LEIGH SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
325 N. STATE OF FRANKLIN ROAD, GROUND FL, JOHNSON CITY, TN 37604
(423) 439-7320
Mailing address
2017 KATELYN DR, ELIZABETHTON, TN 37643-3855
(615) 218-3757

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
23350
TN
2080P0207X
Pediatric Hematology & Oncology Physician
23350
TN
363L00000X
Nurse Practitioner
Primary
23350
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q033758
TN
Enumeration date
10/17/2017
Last updated
01/25/2024
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