NPI 1023671617

Nicole Maalouf Shively, PA

Practitioner Physician Assistant Roanoke, VA

Practice location

Address: 1622 Westover Ave SW, Roanoke, VA 24015-5216
Phone: (339) 368-1887

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 0010-10795 (NC)

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Registry record

NPI: 1023671617
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Apr 2019
Record last updated: 31 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.