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General NPI Number Information
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NPI Number | 1710177340
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Entity Type | Individual
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Provider Name | LAURA M SHAW DNP
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Gender | Female
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 309 FREEDOM RD
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City | OXFORD
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State | WI
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Zip | 53952-9309
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Country | US
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Telephone | 608-432-4978
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Fax |
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Provider Business Mailing Address
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Address Line | 309 FREEDOM RD
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City | OXFORD
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State | WI
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Zip | 53952-9309
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Country | US
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Telephone | 608-432-4978
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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 | 89-033
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License Number State | WI
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