Doctor Name: | BRITTANY SHAW |
NPI Number: | 1073905923 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, FNP-BC |
License Number: | R888982 |
Business Practice Address: | 4402 E Aloha Dr Suite 16 Diamondhead, MS - 395253349 |
Business Phone Number: | 2283649001 |
Business Fax Number: | |
Mailing Address: | 551 White Chapel Rd, CARRIERE |
State: | MS |
Postal Code: | 394269292 |
Phone Number: | 6015077826 |
Fax Number: | |
NPI Enumeration Date: | 03/02/2015 |
NPI Last Update Date: | 03/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R888982 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |