Provider Demographics
NPI:1023069952
Name:SHOCKLEY, MICHELE (ARNP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:SHOCKLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 JUPITER LAKES BLVD
Mailing Address - Street 2:BUILDING 2000
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7180
Mailing Address - Country:US
Mailing Address - Phone:561-748-1888
Mailing Address - Fax:
Practice Address - Street 1:136 JUPITER LAKES BLVD
Practice Address - Street 2:BUILDING 2000
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7180
Practice Address - Country:US
Practice Address - Phone:561-748-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2754972363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health