Individual
MELISSA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
Mailing address
PO BOX 392552, PITTSBURGH, PA 15251-9500
(512) 792-4402
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28216522A
IN
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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