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Individual

SAMANTHA ANN SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1605 W FAIRBANKS AVE, WINTER PARK, FL 32789-4603
(407) 845-8356
Mailing address
1605 W FAIRBANKS AVE, WINTER PARK, FL 32789-4603
(407) 845-8356

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11003385
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11003385
FL

Other

Enumeration date
09/09/2019
Last updated
07/28/2025
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