Individual
VICTORIA L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN196723
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196723
REGISTERED NURSE
OH
01
—
SHA1-0426-7258
NURSE PRACTITIONER
OH
Enumeration date
03/20/2007
Last updated
03/17/2010
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