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NPI Code Detail

MEDICARE: ELIZABETH ANN SHOCKLEY NP

MEDICARE: ELIZABETH ANN SHOCKLEY NP
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
1363L00000XNurse Practitioner0024164686VA
2363L00000XNurse Practitioner5010297NC
3363LF0000XFamily Nurse Practitioner5010297NC
4363LF0000XFamily Nurse Practitioner00241646863VA

General Provider Information

NPI Number : 1861499691
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANN SHOCKLEY NP
Provider Business Mailing Address
First Line : 18981 JEB STUART HWY
Second Line :
City : STUART
State : VA
Zip : 24171-5146
Country : US
Telephone Number : 276-694-4416
Fax Number : 276-694-4308
Provider Business Practice Location Address
First Line : 18877 JEB STUART HWY
Second Line :
City : STUART
State : VA
Zip : 24171-5223
Country : US
Telephone Number : 276-694-4466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 05/10/2023

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Directions to “ ELIZABETH ANN SHOCKLEY NP” Practice Location

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