Individual
AUTUM SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7300
Mailing address
8501 STOCKS RD, JACKSONVILLE, FL 32220-1222
(904) 707-9749
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9424972
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11032916
FL
Other
Enumeration date
05/01/2024
Last updated
11/18/2024
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