ETHAN JOHN SHAW LPN
NPI 1346751823
Licensed Practical Nurse in University Park, PA

Active since October 24, 2017
438 STUDENT HEALTH CTR, UNIVERSITY PARK, PA 16802(814) 863-0774 Get Directions Write a Review

NPPES record last updated: October 24, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ethan John Shaw Lpn NPPES

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

ETHAN JOHN SHAW LPN (NPI 1346751823) is an individual licensed practical nurse in University Park, Pennsylvania, licensed in Pennsylvania (PN271630) and active in the NPI registry since October 2017.

NPPES Registry Identity

NPI1346751823
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameETHAN JOHN SHAWCredential: LPN
Location Address438 STUDENT HEALTH CTRUniversity Park, PA 16802-2129
Mailing Address413 Arc RdWest Decatur, PA 16878-8540 · (814) 592-8509
Sole ProprietorNo
Enumeration DateOctober 24, 2017
NPI 1346751823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License Licensed in PA · PN271630
Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

438 STUDENT HEALTH CTR, University Park, PA 16802

Other Providers at the Same Location NPPES 3

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

Licensed Practical Nurse
438 STUDENT HEALTH CTR
UNIVERSITY PARK, PA 16802
Licensed Practical Nurse
438 STUDENT HEALTH CTR
UNIVERSITY PARK, PA 16802
Clinical Nurse Specialist
438 STUDENT HEALTH CTR
UNIVERSITY PARK, PA 16802

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1346751823, enumerated as an "individual" on October 24, 2017.

The provider is located at 438 STUDENT HEALTH CTR UNIVERSITY PARK, PA 16802 and the phone number is (814) 863-0774.

Licensed Practical Nurse with taxonomy code 164W00000X.