Individual provider · Type 1 NPI

Nicholas Kyle Shockley, FNP

Family Nurse Practitioner · St. Louis, MO

NPI number 1649766288 Active

Practice location

10012 Kennerly Rd Ste 406
St. Louis, MO 63128-2197

Fax (314) 525-4957

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X2021027097 (MO)
Family Nurse Practitioner 363LF0000X209.017506 (IL)
Nurse Practitioner 363L00000X209017506 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1649766288

Nicholas Kyle Shockley, FNP's National Provider Identifier is 1649766288, issued on Jul 6, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in St. Louis, MO. The record was last updated on Apr 29, 2026.