Individual
KIMBERLY ANN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 CODY RD S, LE CLAIRE, IA 52753-9579
(563) 289-2273
(563) 289-1605
Mailing address
11532 61ST AVE, BLUE GRASS, IA 52726-9660
(563) 381-5041
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005650
GA
363AM0700X
Medical Physician Assistant
001653
IA
Other
Enumeration date
01/16/2006
Last updated
04/23/2012
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