Provider Demographics
NPI:1689449589
Name:SHAW, MARGARET ANNE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANNE
Last Name:SHAW
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 COUNTY HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:NY
Mailing Address - Zip Code:12776-2520
Mailing Address - Country:US
Mailing Address - Phone:607-437-9874
Mailing Address - Fax:
Practice Address - Street 1:3635 COUNTY HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:NY
Practice Address - Zip Code:12776-2520
Practice Address - Country:US
Practice Address - Phone:607-437-9874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY578181-01163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy