Madison Shockey
Nurse Practitioner, Family in St Petersburg, FL. Individual provider (NPI-1).
NPI number1619709060
StatusActive
Last updated in NPPESAug 20, 2024
Details
- NPI
- 1619709060
- Entity type
- Individual (NPI-1)
- Name
- Madison Shockey
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 15, 2024
- Certification date
- Aug 20, 2024
- Last updated
- Aug 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 11034761 | FL | Yes |
Practice location
5571 4th St NSt Petersburg, FL 33703-2251
Phone 727-525-7852
Mailing address
10980 Oak St Ne Unit 4205St Petersburg, FL 33716-3360
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