Individual
CASEY J SHALKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-PCNP
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(315) 646-7797
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95021828
CA
Other
Enumeration date
08/24/2022
Last updated
08/13/2024
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