Individual
JENNIFER MARIE SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
601 S COLLEGE RD, WILMINGTON, NC 28403-3201
(910) 962-3280
(910) 962-4130
Mailing address
4621 RUNAWAY BAY LN, WILMINGTON, NC 28405-5700
(772) 807-0903
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/03/2019
Last updated
07/29/2025
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