Individual
MARSHA DIANE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
200 UNIVERSITY BLVD, TUSCALOOSA, AL 35401-1250
(205) 759-0407
(205) 759-0845
Mailing address
200 UNIVERSITY BLVD, TUSCALOOSA, AL 35401-1250
(205) 759-0407
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-020751
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00104410
R/R GROUP
—
Enumeration date
07/21/2006
Last updated
07/08/2007
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