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NPI Code Detail

MEDICARE: EMERALD SHOCKLEY

MEDICARE: EMERALD SHOCKLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse539629OH

General Provider Information

NPI Number : 1669338547
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMERALD SHOCKLEY
Provider Business Mailing Address
First Line : 141 WELLINGTON PL UNIT A208
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-2693
Country : US
Telephone Number : 513-801-1194
Fax Number :
Provider Business Practice Location Address
First Line : 2155 DANA AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45207-1340
Country : US
Telephone Number : 513-601-0313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ EMERALD SHOCKLEY ” Practice Location

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