Antonette Shaw CRNP - PC

NPI 1790115251 - Nurse Practitioner - 363LP0200X

NPI Details
NPI 1790115251
Gender Female
Enumeration Date 11/20/2013
Last Updated 08/27/2015
Entity Type Individual
Active Over 3 years ago
Practice Location
4417 N 6TH ST
PHILADELPHIA PA, 19140-2319, US
Phone (215) 302-3600
Fax
Business Location
4417 N 6TH ST
PHILADELPHIA PA, 19140-2319, US
Phone
Fax
Toxanomy
Taxonomy Code 363LP0200X
License State Pennsylvania
License Number SP013412
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According to our database, Ms. Antonette Shaw CRNP - PC NPI is 1790115251, taxonomy code is 363LP0200X and license number is SP013412, license state is located at Pennsylvania. Antonette Shaw CRNP - PC physically located at 4417 N 6th St, Philadelphia PA, 19140-2319. NPI Number Antonette Shaw CRNP - PC has the Individual type.

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1790115251 NPI number is provided on an as is basis without warranty of any kind. 1790115251 is maintained by the National Plan & Provider Enumeration System. The contents of Antonette Shaw CRNP - PC are for informational purposes only.