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General NPI Number Information
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NPI Number | 1942186366
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Entity Type | Individual
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Provider Name | RITA ANGELA SHAW APRN, FNP-BC
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Gender |
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 9904 RED BIRD TER
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-4784
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Country | US
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Telephone | 240-552-5752
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Fax |
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Provider Business Mailing Address
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Address Line | 9904 RED BIRD TER
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-4784
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Country | US
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Telephone | 240-552-5752
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R151515
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License Number State | MD
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