Individual
MS. AUDREY LYNN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 ROUTE 73 N UPPR LEVELB, MARLTON, NJ 08053-4524
(856) 355-7137
(856) 355-7138
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00544000
NJ
363A00000X
Physician Assistant
OA003112
PA
363AM0700X
Medical Physician Assistant
MA056344
PA
Other
Enumeration date
09/27/2013
Last updated
08/08/2024
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