REBECCA ANNE SHAW PMHNP-BC NPI 1003405739

NPI Information

NPI: 1003405739
Provider Name: REBECCA ANNE SHAW, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: 2ND CHANCE TREATMENT CENTERS LLC

PECOS Registration: Yes

Address:
18555 N 79TH AVE STE D107
GLENDALE, AZ
ZIP 85308
Phone: (623) 777-3477
Get Directions

Rebecca Anne Shaw, PMHNP-BC is a psychiatric/mental health nurse practitioner in Glendale, AZ with 3 years of experience. Rebecca Anne Shaw, PMHNP-BC NPI is 1003405739. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

18555 N 79TH AVE STE D107
GLENDALE, AZ
ZIP 85308-040
Phone: (623) 777-3477
Fax: (623) 777-3478

The NPI 1003405739 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 1/17/2021 and was last updated on 12/2/2021.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	262350	ARIZONA	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: 11/14/2023

NPI Synchronization or Removal

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