Provider Demographics
NPI:1659152890
Name:SHAW, NOELLE ELIZABETH
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:ELIZABETH
Last Name:SHAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:ELIZABETH
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2300 CAPITOL AVE STE B27
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3672
Mailing Address - Country:US
Mailing Address - Phone:307-635-1297
Mailing Address - Fax:
Practice Address - Street 1:2300 CAPITOL AVE STE B27
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3672
Practice Address - Country:US
Practice Address - Phone:307-635-1297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY4532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist