Individual
TERA MARIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
407 N. MIAMI ST, WEST MILTON, OH 45383
(937) 430-2213
Mailing address
407 N MIAMI ST, WEST MILTON, OH 45383-1911
(937) 430-2213
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.0034001
OH
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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