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Nicholas Kyle Shockley, FNP
Nurse Practitioner in Carbondale, Illinois
NPI 1649766288

Nicholas Kyle Shockley is a Nurse Practitioner based in Carbondale, IL. Nicholas Kyle Shockley practices in Carbondale, IL and has the professional credentials of FNP. The NPI Number for Nicholas Kyle Shockley is 1649766288 and holds a License No. 209.017506 (Illinois).

The current practice location address for Nicholas Kyle Shockley is 305 W Jackson St Ste 206, Carbondale, IL and can be reached out via phone at 618-457-3006. You can also correspond with Nicholas Kyle Shockley through the mailing address at PO BOX 3988, CARBONDALE, IL - 62902-3988 (mailing address contact number: 618-457-5200).

Location: 305 W Jackson St Ste 206, Carbondale, IL, 62902-3988
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649766288
Provider Name
Nicholas Kyle Shockley
Credential
FNP
Provider Entity Type
Individual
Gender
Male
Address
305 W Jackson St Ste 206, Carbondale, IL, 62902-3988
Phone Number
618-457-3006
Fax Number
Provider Enumeration Date
07/06/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
305 W Jackson St Ste 206
City
Carbondale
State
Illinois
Zip
62901-1474
Phone Number
618-457-3006
Fax Number
person
Provider Business Mailing Address Details
Address
305 W Jackson St Ste 206
City
Carbondale
State
Illinois
Zip
62901-1474
Phone Number
618-457-3006
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
209017506 (Illinois)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209.017506 (Illinois)
Definition
Definition to come...
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