Provider Demographics
NPI:1053877399
Name:PEOPLES SHAW LLC
Entity type:Organization
Organization Name:PEOPLES SHAW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER- OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:PEOPLES
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:660-651-1391
Mailing Address - Street 1:113 E HIGHWAY 151
Mailing Address - Street 2:
Mailing Address - City:LEONARD
Mailing Address - State:MO
Mailing Address - Zip Code:63451-1024
Mailing Address - Country:US
Mailing Address - Phone:660-762-4291
Mailing Address - Fax:
Practice Address - Street 1:101 N CENTER ST
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:MO
Practice Address - Zip Code:63437-1701
Practice Address - Country:US
Practice Address - Phone:660-699-2240
Practice Address - Fax:660-699-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care