Individual
TARYN BLAINE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PNP-PC
Contact information
Practice address
1995 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-2405
(803) 928-5525
(803) 928-5505
Mailing address
2214 OLD CHEROKEE RD, LEXINGTON, SC 29072-9725
(803) 520-9380
(803) 520-5972
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
257284
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
32800
TN
Other
Enumeration date
10/14/2022
Last updated
06/07/2023
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