Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANDREA LYN SHAW
Active Sole ProprietorANDREA LYN SHAW is a Licensed Practical Nurse healthcare provider located in RIDGWAY, Illinois. NPI 1174286736 is currently active in the NPPES registry. Verify at CMS.
Licensed Practical Nurse · RIDGWAY, IL
Registration Details
- NPI Number
- 1174286736
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 20, 2021 (4.832315629914 yrs)
- Last Updated
- Oct 20, 2021
- License
-
043119608 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
900 W RACE STRIDGWAY, IL, 629791150Browse IL providers · Browse ZIP 62979
- Phone
- 6182728831
- Fax
- 6182727118
- Primary Specialty
-
Licensed Practical Nurse
164W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.