MS. JESSICA R SHAW AGACNP-BC NPI 1417969429

NPI Information

NPI: 1417969429
Provider Name: MS. JESSICA R SHAW, AGACNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
800 W MAGNOLIA AVE
FORT WORTH, TX
ZIP 76104
Phone: (817) 759-7000
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MS. Jessica R Shaw, AGACNP-BC is a family nurse practitioner in Fort Worth, TX with 8 years of experience. MS. Jessica R Shaw, AGACNP-BC NPI is 1417969429. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduation Year:2016

The provider's business location address is:

800 W MAGNOLIA AVE
FORT WORTH, TX
ZIP 76104-611
Phone: (817) 759-7000
Fax: (817) 759-7027

The NPI 1417969429 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/12/2006 and was last updated on 2/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WN0800X	Registered Nurse	Neuroscience	637618	TEXAS	No
2	363LA2100X	Nurse Practitioner	Acute Care	AP132391	TEXAS	No
3	363LF0000X	Nurse Practitioner	Family	AP132391	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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