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1063020279
ALICE CATHERINE SHAW
SOUTH BEND, IN
NPI
1063020279
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: IN 71010179A)
Enumeration Date
2020-07-14
Last Update Date
2023-05-24
Business Address
ALICE CATHERINE SHAW FNP
4440 N PORTAGE AVE
SOUTH BEND, IN 46628-9570
Phone number: 574-204-6200
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Mailing Address
ALICE CATHERINE SHAW FNP
4440 N PORTAGE AVE
SOUTH BEND, IN 46628
Phone number:
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