Ethan John Shaw, LPN
NPI #1346751823 in University Park, Pennsylvania
Provider Information
- NPI Number
- 1346751823
- Entity Type
- Individual
- Name
- Ethan John Shaw, LPN
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Licensed Practical Nurse
- Credential
- LPN
- Enumeration Date
- Oct 24, 2017
- Last Updated
- Oct 24, 2017
Practice Location
- Address
- 438 STUDENT HEALTH CTR
- City
- University Park
- State
- Pennsylvania
- ZIP Code
- 16802-2129
- Phone
- (814) 863-0774
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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