MEDICARE: RAMONA SHAW RN

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
1	163WC1500X	Community Health Registered Nurse	399300	OH
2	163WH0200X	Home Health Registered Nurse	399300	OH
3	163WM0705X	Medical-Surgical Registered Nurse	399300	OH
4	163WP2201X	Ambulatory Care Registered Nurse	399300	OH

General Provider Information

NPI Number	:	1699191171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMONA SHAW RN

Provider Business Mailing Address
First Line	:	1043 W SEYMOUR AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45216-1837
Country	:	US
Telephone Number	:	513-373-5051
Fax Number	:

Provider Business Practice Location Address
First Line	:	1043 W SEYMOUR AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45216-1837
Country	:	US
Telephone Number	:	513-373-5051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2014
Last Update Date	:	03/08/2014

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Directions to “ RAMONA SHAW RN” Practice Location

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