Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | ARNP2754972 | FL |
NPI | 1023069952 |
---|---|
Provider Name | Michele Shockley |
First Address | Jupiter, FL 33458-7180 |
Second Address | Jupiter, FL 33458-7180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 05/09/2013 |