| Doctor Name: | JILL MARIE SHAW |
| NPI Number: | 1457508475 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | R753944 |
| Business Practice Address: | 356 W Cherry St Ackerman, MS - 397358709 |
| Business Phone Number: | 6622853243 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1327, STARKVILLE |
| State: | MS |
| Postal Code: | 397601327 |
| Phone Number: | 6622853243 |
| Fax Number: | |
| NPI Enumeration Date: | 08/20/2008 |
| NPI Last Update Date: | 06/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R753944 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |