Individual
KALINDA JO SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3411 PROFESSIONAL PARK DR, MARION, IL 62959-6394
(618) 969-8630
Mailing address
3411 PROFESSIONAL PARK DR, MARION, IL 62959-6394
(618) 969-8630
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041444043
IL
363L00000X
Nurse Practitioner
Primary
209023069
IL
363LF0000X
Family Nurse Practitioner
209023069
IL
Other
Enumeration date
06/25/2021
Last updated
03/23/2026
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