Organization
SELF-EMPLOYED NP DEVELOPMENT CO., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA SHAW (PRESIDENT)
(614) 476-6931
Entity
Organization
Contact information
Practice address
104 N STYGLER RD, GAHANNA, OH 43230-2437
(614) 476-6931
Mailing address
PO BOX 30780, COLUMBUS, OH 43230-0780
(614) 476-6931
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/14/2008
Last updated
04/20/2012
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