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General NPI Number Information
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NPI Number | 1750775482
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Entity Type | Individual
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Provider Name | ASHLEY SHOOK LPN
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Gender | Female
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 08/17/2024
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Provider Practice Location Address
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Address Line | 1950 COOK ST STE D
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City | DYERSBURG
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State | TN
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Zip | 38024-1899
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Country | US
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Telephone | 731-285-7999
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Fax | 731-285-6917
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Provider Business Mailing Address
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Address Line | 2220 TWILIGHT DR
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City | DYERSBURG
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State | TN
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Zip | 38024-1926
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Country | US
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Telephone | 731-589-8280
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 76692
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License Number State | TN
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