Healthcare Provider Details

I. General information

NPI: 1528672292
Provider Name (Legal Business Name): MEGAN SHOCKLEY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CAMDEN AVE
SALISBURY MD
21801-6860
US

IV. Provider business mailing address

12520 SELSEY RD
OCEAN CITY MD
21842-9128
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-6262
  • Fax:
Mailing address:
  • Phone: 410-713-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR211748
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: