Doctor Name: | PATRICIA LEA SHUE |
NPI Number: | 1306238654 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PNP |
License Number: | 28154600A |
Business Practice Address: | 1016 W Spruce St Unit A Rawlins, WY - 823015371 |
Business Phone Number: | 3073248717 |
Business Fax Number: | 3073278496 |
Mailing Address: | 1016 W Spruce St Unit A, RAWLINS |
State: | WY |
Postal Code: | 823015371 |
Phone Number: | 3073248717 |
Fax Number: | 3073278496 |
NPI Enumeration Date: | 02/24/2015 |
NPI Last Update Date: | 02/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 28154600A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |