Basic Information
| Provider Information | |||||||||
| NPI: | 1326365701 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAWS | ||||||||
| FirstName: | SHEA | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 MEDICAL CAMPUS DR | ||||||||
| Address2: | YCHD | ||||||||
| City: | BURNSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287149004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286826118 | ||||||||
| FaxNumber: | 8286826262 | ||||||||
| Practice Location | |||||||||
| Address1: | 202 MEDICAL CAMPUS DR | ||||||||
| Address2: | YCHD | ||||||||
| City: | BURNSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287149004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286826118 | ||||||||
| FaxNumber: | 8286826262 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2010 | ||||||||
| LastUpdateDate: | 04/26/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 195933 | NC | Y | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | 195933 | 01 | NC | NC NURSES LICENSE # | OTHER |