Individual provider · Type 1 NPI

Mallory Rich Shatlock, NURSE PRACTITIONER

Nurse Practitioner · Winston Salem, NC

NPI number 1548728249 Active

Practice location

190 Kimel Park Dr Ste 155
Winston Salem, NC 27103-6946

Fax (336) 765-6964

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice locations

  • 3535 Grandview Pkwy Ste 150, Birmingham, AL 35243-2027 · (205) 250-6805

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner 363LA2100X1-159191 (AL)
Nurse Practitioner Primary 363L00000X5021115 (NC)

Nurse Practitioner: (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 wit…

16 other providers at this address

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About NPI 1548728249

Mallory Rich Shatlock, NURSE PRACTITIONER's National Provider Identifier is 1548728249, issued on Mar 12, 2019. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Winston Salem, NC. The record was last updated on Dec 30, 2024.