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General NPI Number Information
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NPI Number | 1679665566
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Entity Type | Individual
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Provider Name | SHOBHNA SHUKLA CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 601 NEW JERSEY AVE NW STE 200
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City | WASHINGTON
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State | DC
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Zip | 20001-3030
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Country | US
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Telephone | 888-663-6331
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 12401 DALEWOOD DRIVE
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City | SILVER SPRING
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State | MD
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Zip | 20906
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Country | US
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Telephone | 301-321-3259
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Fax | 301-942-0137
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R193340
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License Number State | MD
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