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General NPI Number Information
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NPI Number | 1790674075
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Entity Type | Individual
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Provider Name | LEAH SHAW
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 706 N BARNES AVE
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City | HASTINGS
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State | NE
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Zip | 68901-4219
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Country | US
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Telephone | 785-787-5543
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 66
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City | HOLSTEIN
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State | NE
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Zip | 68950-0066
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Country | US
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Telephone |
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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 | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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