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NPI Code Detail

MEDICARE: SARAH LOUISE SHAW NP

MEDICARE: SARAH LOUISE SHAW NP
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
1363LF0000XFamily Nurse Practitioner04199RI

General Provider Information

NPI Number : 1275350696
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH LOUISE SHAW NP
Provider Business Mailing Address
First Line : 455 TOLL GATE RD
Second Line :
City : WARWICK
State : RI
Zip : 02886-2759
Country : US
Telephone Number : 401-273-0641
Fax Number : 401-273-2919
Provider Business Practice Location Address
First Line : 2140 MENDON RD
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-3843
Country : US
Telephone Number : 401-642-2072
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2024
Last Update Date : 12/15/2025

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