Individual
LATASHA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3 RIVERSVILLE RD, GREENWICH, CT 06831-3627
(203) 258-4582
Mailing address
3 RIVERSVILLE RD, GREENWICH, CT 06831-3627
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12430
CT
Other
Enumeration date
12/27/2023
Last updated
12/27/2023
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