MEDICARE: BAYLEE JOELLE SHAW APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	71014522A	IN
2	163W00000X	Registered Nurse	28246833C	IN

General Provider Information

NPI Number	:	1538874748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAYLEE JOELLE SHAW APRN, FNP-C

Provider Business Mailing Address
First Line	:	7015 US 31 STE B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-8619
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7015 US 31 STE B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-8619
Country	:	US
Telephone Number	:	317-724-1939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2023
Last Update Date	:	08/21/2025

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