Provider Demographics
NPI:1053448753
Name:SHAW, KATHY F (RN, DNP)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:F
Last Name:SHAW
Suffix:
Gender:F
Credentials:RN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13120 E 19TH AVE
Mailing Address - Street 2:MAIL STOP C 288-19
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2567
Mailing Address - Country:US
Mailing Address - Phone:303-724-8528
Mailing Address - Fax:
Practice Address - Street 1:3525 W OXFORD AVE # G3
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80236-3106
Practice Address - Country:US
Practice Address - Phone:303-797-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0200380163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator