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General NPI Number Information
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NPI Number | 1043824501
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Entity Type | Individual
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Provider Name | CHRISTINA JEAN SHOCKLEY FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1750 MARKET DR STE H
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City | DICKINSON
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State | ND
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Zip | 58601-6181
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Country | US
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Telephone | 701-456-1221
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Fax | 701-888-5313
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Provider Business Mailing Address
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Address Line | 1750 MARKET DR STE H
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City | DICKINSON
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State | ND
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Zip | 58601-6181
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Country | US
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Telephone | 701-456-1221
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Fax | 701-888-5313
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R33717
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R33717
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R33717
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License Number State | ND
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