Provider Demographics
NPI:1023132313
Name:MCSHAW, ELVIN (RN)
Entity type:Individual
Prefix:MRS
First Name:ELVIN
Middle Name:
Last Name:MCSHAW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-3204
Mailing Address - Country:US
Mailing Address - Phone:919-690-1847
Mailing Address - Fax:919-690-1847
Practice Address - Street 1:36 CHURCH ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-3204
Practice Address - Country:US
Practice Address - Phone:919-690-1847
Practice Address - Fax:919-690-1847
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3449374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418212OtherIN HOME AIDE SERVICE
NC6601536Medicaid