Provider Demographics
NPI:1750147799
Name:SHAW, ERIKA DREW (APRN)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:DREW
Last Name:SHAW
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:DREW
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1317 PINEHURST CIR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3818
Mailing Address - Country:US
Mailing Address - Phone:917-605-3730
Mailing Address - Fax:
Practice Address - Street 1:200 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-3049
Practice Address - Country:US
Practice Address - Phone:785-539-4644
Practice Address - Fax:785-539-8010
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82747-022363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner