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Individual

JANA LANETTE SHOCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1002 WISHARD BLVD, INDIANAPOLIS, IN 46202-4163
(317) 274-4779
(317) 948-9806
Mailing address
PO BOX 713577, CHICAGO, IL 60677-0403

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
28090603A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71002365A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000795010
ANTHEM
IN
05
201074150
IN
01
P01292378
RAILROAD MEDICARE
IN
Enumeration date
06/06/2012
Last updated
02/26/2026
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