Jacob Winton Shaw, NP
Nurse Practitioner in Winnsboro, SC. Individual provider (NPI-1).
NPI number1356757140
StatusActive
Last updated in NPPESSep 1, 2015
Details
- NPI
- 1356757140
- Entity type
- Individual (NPI-1)
- Name
- Jacob Winton Shaw
- Credential
- NP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 1, 2014
- Last updated
- Sep 1, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 10825 | SC | Yes |
Practice location
213 W Liberty StWinnsboro, SC 29180-1421
Phone 803-635-2414
Mailing address
213 W Liberty StWinnsboro, SC 29180-1421
Phone 803-635-2414
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