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1093226789
STACEY LYNN SHAW
NORTH MYRTLE BEACH, SC
NPI
1093226789
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: SC 20127)
Enumeration Date
2017-10-20
Last Update Date
2023-09-25
Business Address
Ms. STACEY LYNN SHAW APRN
2423 HIGHWAY 17 S
NORTH MYRTLE BEACH, SC 29582-4343
Phone number: 843-919-0700
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Mailing Address
Ms. STACEY LYNN SHAW APRN
286 JUNCO CIR
LONGS, SC 29568-6965
Phone number: 843-321-5099
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