Katie Rae Shaw, FNP-C
Nurse Practitioner, Family in Bowie, TX. Individual provider (NPI-1).
NPI number1841908274
StatusActive
Last updated in NPPESDec 5, 2022
Details
- NPI
- 1841908274
- Entity type
- Individual (NPI-1)
- Name
- Katie Rae Shaw
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 15, 2022
- Certification date
- Dec 5, 2022
- Last updated
- Dec 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 1099832 | TX | Yes |
| 163W00000X | Registered Nurse | 920107 | TX |
Practice location
1010 N Mill StBowie, TX 76230-3120
Phone 940-872-1121
Mailing address
1010 N Mill StBowie, TX 76230-3120
Phone 940-366-5448
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