Provider Demographics
NPI:1932247269
Name:SHOCKLEY, SHARON (RN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SHOCKLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-1001
Mailing Address - Country:US
Mailing Address - Phone:703-528-2342
Mailing Address - Fax:
Practice Address - Street 1:1725 N GEORGE MASON DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3675
Practice Address - Country:US
Practice Address - Phone:703-228-4856
Practice Address - Fax:703-228-5234
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001096778163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical