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Individual

NICOLE SHOCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
4325 GRAND AVE, DULUTH, MN 55807-2730
(218) 722-1497
(218) 722-6239
Mailing address
2222 E 5TH ST, SUPERIOR, WI 54880-3709
(715) 392-1955
(715) 392-1935

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1745474
MN
163W00000X
Registered Nurse
241302
WI
363L00000X
Nurse Practitioner
10568
WI
363L00000X
Nurse Practitioner
Primary
4971
MN

Other

Enumeration date
03/10/2017
Last updated
01/30/2024
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