Provider Demographics
NPI:1376652875
Name:SHAW, NORMA J (RN, MS, CS)
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:J
Last Name:SHAW
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Gender:F
Credentials:RN, MS, CS
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Mailing Address - Street 1:1162 G A R HWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4224
Mailing Address - Country:US
Mailing Address - Phone:508-674-0038
Mailing Address - Fax:508-673-1638
Practice Address - Street 1:1162 G A R HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4224
Practice Address - Country:US
Practice Address - Phone:508-674-0038
Practice Address - Fax:508-673-1638
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA91459364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851870Medicaid
MA6209971OtherUBH
MA20025AOtherVALUE OPTIONS
MAPN0310OtherBC BS OF MASS
MA771650OtherTUFTS
MA407177OtherBLUE CHIP
MA3475-1OtherBC BS OF RI
P2099943OtherOXFORD HEALTH PLANS
MA6209971OtherUBH