Individual provider · Type 1 NPI

Logan Jay Shockley, FNP-C

Family Nurse Practitioner · Rolla, MO

NPI number 1295374148 Active

Practice location

1060 W 10th St
Rolla, MO 65401-2905

Fax (573) 458-8363

Mailing address

1050 W 10th St
Rolla, MO 65401-2905

Other practice locations

  • 1000 W 10th St, Rolla, MO 65401-2905 · (573) 458-8899
  • 1000 W 10th St, Rolla, MO 65401-2905 · (573) 364-9000

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X2016022013 (MO)
Family Nurse Practitioner Primary 363LF0000X2020003116 (MO)

Family Nurse Practitioner: Definition to come...

16 other providers at this address

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About NPI 1295374148

Logan Jay Shockley, FNP-C's National Provider Identifier is 1295374148, issued on Dec 24, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Rolla, MO. The record was last updated on Mar 20, 2025.