Provider Demographics
NPI:1609341502
Name:SHAW, ALLISON PEOPLES (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:PEOPLES
Last Name:SHAW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:MO
Mailing Address - Zip Code:63437-1701
Mailing Address - Country:US
Mailing Address - Phone:660-651-1391
Mailing Address - Fax:
Practice Address - Street 1:101 N CENTER ST
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:MO
Practice Address - Zip Code:63437-1701
Practice Address - Country:US
Practice Address - Phone:660-699-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-06
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018036804363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily