Individual
ERICA D SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2615 EDWARDS ST, ALTON, IL 62002-3915
(618) 462-2331
(618) 462-7160
Mailing address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
(618) 937-1440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.433193
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209020833
IL
Other
Enumeration date
03/27/2018
Last updated
02/24/2020
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