Individual
AMY MICHELLE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, NNP
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-3671
Mailing address
176 HEATHERLAND DR, BETHALTO, IL 62010-1894
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
2003018052
MO
Other
Enumeration date
04/12/2007
Last updated
08/05/2012
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