Individual provider · Type 1 NPI
Stacey L. Shaw, ARNP
Family Nurse Practitioner · Port Orange, FL
NPI number
1366922882
Active
Practice location
1690 Dunlawton Ave Ste 230
Port Orange, FL 32127-8980
Mailing address
1690 Dunlawton Ave
Port Orange, FL 32127-8979
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 2878322 (FL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1366922882
Stacey L. Shaw, ARNP's National Provider Identifier is 1366922882, issued on Aug 14, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Port Orange, FL. The record was last updated on Aug 14, 2018.