Provider Demographics
NPI:1447812995
Name:SHAW, JENNIFER JOAN (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOAN
Last Name:SHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:988435 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8435
Mailing Address - Country:US
Mailing Address - Phone:402-559-5804
Mailing Address - Fax:402-559-9213
Practice Address - Street 1:988435 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-8435
Practice Address - Country:US
Practice Address - Phone:402-559-5804
Practice Address - Fax:402-559-9213
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE86252084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology