Individual provider · Type 1 NPI

Kelly Shaw

Lactation Consultant (Registered Nurse) · Urbana, IL

NPI number 1174495014 Active

Practice location

611 W Park St
Urbana, IL 61801-2501

Mailing address

1096 Bucks Pond Rd
Monticello, IL 61856-8058

Specialties and licenses

TaxonomyCodeLicense
Lactation Consultant (Registered Nurse) Primary 163WL0100X041447434 (IL)

Lactation Consultant (Registered Nurse): Definition to come...

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About NPI 1174495014

Kelly Shaw's National Provider Identifier is 1174495014, issued on Sep 20, 2025. The primary taxonomy on file is Lactation Consultant (Registered Nurse) (163WL0100X), and the practice location is in Urbana, IL. The record was last updated on Sep 20, 2025.