IndividualActive
Andrea Shaw
NPI 1174286736 · Licensed Practical Nurse · Ridgway, IL
Provider details
- NPI number
- 1174286736
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 043119608 (IL)
Specialties & taxonomies
Nursing Service Providers
Practice location
900 W Race St
Ridgway, IL 62979-1150
Phone: (618) 272-8831
Fax: (618) 272-7118
Approximate (ZIP-level) locationGet directions
Mailing address
900 W Race St
Ridgway, IL 62979-1150
Registry dates
- Enumerated
- 2021-10-20
- Last updated
- 2021-10-20
- Certified
- 2021-10-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.