Individual
JILL MARIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 939-1736
Mailing address
6225 STATE HWY 161 STE 200, IRVING, TX 75038-2241
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
131675
KY
Other
Enumeration date
12/31/2020
Last updated
05/06/2021
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