Individual
JILLIAN DENISE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
400 E BUSINESS WAY, SHARONVILLE, OH 45241-3089
(952) 687-4088
Mailing address
7450 SILVER LAKE DR, WAYNESVILLE, OH 45068-8230
(937) 903-4442
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.022082
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0306558
—
OH
Enumeration date
11/22/2017
Last updated
04/20/2020
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