Individual
MEKESHA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1196 WAXWING DR UNIT A, FLORENCE, SC 29505-3846
(999) 999-9999
Mailing address
1196 WAXWING DR UNIT A, FLORENCE, SC 29505-3846
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22188
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP7634
—
SC
01
—
SC6095
MEDICARE
SC
Enumeration date
08/28/2018
Last updated
12/04/2025
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