Provider Demographics
NPI:1942186366
Name:SHAW, RITA ANGELA (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:ANGELA
Last Name:SHAW
Suffix:
Gender:X
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9904 RED BIRD TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4784
Mailing Address - Country:US
Mailing Address - Phone:240-552-5752
Mailing Address - Fax:
Practice Address - Street 1:9904 RED BIRD TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4784
Practice Address - Country:US
Practice Address - Phone:240-552-5752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR151515207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine