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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACOB R SHAW

Active

JACOB R SHAW is a Peer Specialist healthcare provider located in BASIN, Wyoming. NPI 1396513719 is currently active in the NPPES registry. Verify at CMS.

Peer Specialist · BASIN, WY

Registration Details

NPI Number
1396513719
Provider Type
Individual
Gender
Male
NPI Issued
Dec 14, 2023 (2.6913379637087 yrs)
Last Updated
Dec 14, 2023
License
143 (WY)

Practice Information

Address
116 SOUTH 3RD STREET
BASIN, WY, 82410
Browse WY providers · Browse ZIP 82410
Phone
3075682020
Primary Specialty
Peer Specialist
175T00000X
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.