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General NPI Number Information
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NPI Number | 1821709189
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Entity Type | Individual
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Provider Name | CHELSEA SHOCK DNP
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Gender | Female
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 1803 YORK RD
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City | TIMONIUM
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State | MD
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Zip | 21093-5119
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Country | US
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Telephone | 443-432-2767
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Fax |
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Provider Business Mailing Address
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Address Line | 435 E BROADWAY
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City | BEL AIR
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State | MD
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Zip | 21014-3203
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Country | US
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Telephone | 410-382-6125
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | LJ-0010453
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R2200384
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R2200384
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License Number State | MD
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