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STACEY LYNN BLACK-SHAW
NPI 1346093184
Registered Nurse - Critical Care Medicine in Detroit, MI

Active since April 10, 2024
4646 JOHN R ST, DETROIT, MI 48201(313) 576-1000 Get Directions Write a Review

NPPES record last updated: April 10, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Stacey Lynn Black-shaw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACEY LYNN BLACK-SHAW (NPI 1346093184) is an individual critical care medicine provider in Detroit, Michigan, licensed in Michigan (4704282646) and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1346093184
Entity TypeIndividualFemale
Primary Taxonomy163WC0200X
Provider Legal NameSTACEY LYNN BLACK-SHAW
Location Address4646 JOHN R STDetroit, MI 48201-1916
Mailing Address17515 Wildemere StDetroit, MI 48221-2724 · (313) 570-9046
Phone(313) 576-1000
Sole ProprietorYes
Enumeration DateApril 10, 2024
NPPES CertifiedApril 10, 2024
✔ NPI 1346093184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Critical Care MedicineNursing Service Providers
Taxonomy Code163WC0200X
License✔ Licensed in MI · 4704282646
4646 JOHN R ST, Detroit, MI 48201
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. YURIJ CHERSTYLO
Student in an Organized Health Care Education/Training Program
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
NAVITHA LONAPPAN
Registered Nurse (Medical-Surgical)
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
SHARI KABETH RN
Registered Nurse (Gastroenterology)
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
DEREK CURTIS THAMARUS
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1294
MOLLY GEORGE
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1316
EDWIN RAYMOND MILLER
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
MR. EDWIN INTIG LOON JR.
Licensed Practical Nurse
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
ASHLEY NICOLE DANIELS MDIV
Religious Nonmedical Practitioner
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacey Black-shaw's NPI number?

The NPI number for Stacey Black-shaw is 1346093184. It was assigned to this individual provider in the NPPES registry on April 10, 2024.

Where is Stacey Black-shaw located?

Stacey Black-shaw practices at 4646 John R St, Detroit, MI 48201. The listed phone number is (313) 576-1000.

What is Stacey Black-shaw's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Critical Care Medicine, with taxonomy code 163WC0200X.

When was this NPI record last updated?

The NPPES record for Stacey Black-shaw was last updated on April 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.