Individual
JACLYN WILLIAMS SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
615 N BONITA AVE, PANAMA CITY, FL 32401-3623
(850) 804-6000
Mailing address
1112 N HAVEN CIR, LYNN HAVEN, FL 32444-2934
(334) 740-8220
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11033320
FL
363LF0000X
Family Nurse Practitioner
11033320
FL
Other
Enumeration date
06/10/2024
Last updated
06/28/2024
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