Provider Demographics
NPI:1598087074
Name:SHAW, KATE (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 WATERVIEW LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-9669
Mailing Address - Country:US
Mailing Address - Phone:704-289-8499
Mailing Address - Fax:
Practice Address - Street 1:500 FINCHER STREET
Practice Address - Street 2:WALGREENS
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112
Practice Address - Country:US
Practice Address - Phone:704-225-9010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist