Provider Demographics
NPI:1891492450
Name:SHOOK, DENISE ANN (APRN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:ANN
Last Name:SHOOK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HUGHES LOOP
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-5503
Mailing Address - Country:US
Mailing Address - Phone:814-594-5419
Mailing Address - Fax:
Practice Address - Street 1:14 HUGHES LOOP
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-5503
Practice Address - Country:US
Practice Address - Phone:814-594-5419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33430363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily