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Addie Shock
Pediatric Nurse Practitioner in Elyria, Ohio
NPI 1215380423

Addie Shock is a Pediatric Nurse Practitioner based in Olmsted Twp, OH and is specialized in Pediatrics. Addie Shock practices in Elyria, OH. The NPI Number for Addie Shock is 1215380423 and holds a License No. RN3810151 (Ohio).

The current practice location address for Addie Shock is 125 E Broad St Ste 302, Elyria, OH and can be reached out via phone at 440-323-0258.

Location: 125 E Broad St Ste 302, Elyria, OH, 44138-4252
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215380423
Provider Name
Addie Shock
Credential
Provider Entity Type
Individual
Gender
Female
Address
125 E Broad St Ste 302, Elyria, OH, 44138-4252
Phone Number
440-323-0258
Fax Number
Provider Enumeration Date
07/22/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
125 E Broad St Ste 302
City
Elyria
State
Ohio
Zip
44035-6447
Phone Number
440-323-0258
Fax Number
person
Provider Business Mailing Address Details
Address
125 E Broad St Ste 302
City
Elyria
State
Ohio
Zip
44035-6447
Phone Number
440-323-0258
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
RN3810151 (Ohio)
Definition
Definition to come...
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