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General NPI Number Information
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NPI Number | 1144042342
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Entity Type | Individual
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Provider Name | TORI A SHAW FNP
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Gender | Female
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 810 S. POWER RD SUITE 101
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City | MESA
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State | AZ
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Zip | 85206
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Country | US
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Telephone | 480-214-0045
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Fax |
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Provider Business Mailing Address
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Address Line | 3926 E SIDESADDLE RD
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-1637
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Country | US
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Telephone | 520-709-8902
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 315937
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License Number State | AZ
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