Individual
KRISTI KAY SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Mailing address
14878 GILES RD APT 308, OMAHA, NE 68138-3141
(402) 359-0969
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
50973
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
RI
05
—
163W00000X
—
RI
Enumeration date
12/29/2020
Last updated
12/29/2020
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