Individual
MS. NAIOMI MICHELLE SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1115 MOUNT ZION RD STE E, MORROW, GA 30260-2266
(770) 960-9999
(770) 960-0931
Mailing address
1115 MOUNT ZION RD, SUITE E, MORROW, GA 30260-2266
(770) 960-9999
(770) 960-0931
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN159492
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134388B
—
GA
01
—
20060526
PEDS NURSING CERTIFICATIO
GA
01
—
472261189
TAX ID
GA
01
—
581238651
TAX ID #
GA
01
—
NCO000006
NATIONAL BD OF PED NURSE
GA
01
—
RN159492
LICENSE #
GA
Enumeration date
02/22/2007
Last updated
10/13/2025
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