Individual
KIM SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2340 SPRING FOREST RD, RALEIGH, NC 27615-7528
(919) 790-6401
Mailing address
2340 SPRING FOREST RD, RALEIGH, NC 27615-7528
(919) 790-6401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200487
NC
Other
Enumeration date
11/07/2007
Last updated
12/13/2013
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