Most Relevant Information
Provider Data
| NPI Number: | 1003405739 |
| Provider Name: | REBECCA ANNE SHAW PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 262350 |
Most Important Dates
| Enumeration Date: | 01/17/2021 |
| Last Updated: | 10/01/2024 |
Provider Practice Location
16620 N 40TH ST STE E1
PHOENIX
AZ
850323357
Practice Location Phone/Fax
| Phone: | 6024649576 |
| Fax: | 4804280475 |
Provider Mailing Location
16620 N 40TH ST STE E1
PHOENIX
AZ
850323357
Provider Mailing Phone/Fax
| Phone: | 6024649576 |
| Fax: | 4804280475 |