Individual
STEPHANIE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1490 BUNKER HILL RD, COLUMBUS, GA 31907-7412
(706) 315-0427
Mailing address
1490 BUNKER HILL RD, COLUMBUS, GA 31907-7412
(706) 315-0427
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN069642
GA
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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