Individual
MRS. JETAL SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
431 KEISLER DR STE 100, CARY, NC 27518-7064
(919) 468-6820
(919) 468-6484
Mailing address
431 KEISLER DR STE 100, CARY, NC 27518-7064
(919) 468-6820
(919) 468-6484
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5007179
NC
Other
Enumeration date
09/23/2014
Last updated
08/04/2020
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