Individual provider · Type 1 NPI

Lisa Petronella Shock, PA

Physician Assistant · Raleigh, NC

NPI number 1962439745 Active

Practice location

4909 Green Rd
Raleigh, NC 27616-3418

Call (919) 790-0288 Map

Mailing address

1929 Kateland Ct
Apex, NC 27502-6611

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X6237 (TN)
Physician Assistant Primary 363A00000X102885 (NC)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1962439745

Lisa Petronella Shock, PA's National Provider Identifier is 1962439745, issued on Jun 27, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Raleigh, NC. The record was last updated on Jul 10, 2025.