Provider Demographics
NPI:1417176561
Name:LAURIE SHOCKLEY DBA ELITE ASSISTING SERVICES
Entity Type:Organization
Organization Name:LAURIE SHOCKLEY DBA ELITE ASSISTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CFA
Authorized Official - Phone:931-260-4919
Mailing Address - Street 1:551 BURTON LN
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-4989
Mailing Address - Country:US
Mailing Address - Phone:931-260-4919
Mailing Address - Fax:888-329-6432
Practice Address - Street 1:551 BURTON LN
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-4989
Practice Address - Country:US
Practice Address - Phone:931-260-4919
Practice Address - Fax:888-329-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty