Provider Demographics
NPI:1306030184
Name:SHOCKLEY, PATRICIA W (RN,PNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:W
Last Name:SHOCKLEY
Suffix:
Gender:F
Credentials:RN,PNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5407 KILLENS POND RD
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-1901
Mailing Address - Country:US
Mailing Address - Phone:302-284-3800
Mailing Address - Fax:302-284-3892
Practice Address - Street 1:5407 KILLENS POND RD
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:DE
Practice Address - Zip Code:19943-1901
Practice Address - Country:US
Practice Address - Phone:302-284-3800
Practice Address - Fax:302-284-3892
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0012226364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics