Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Courtney Leigh Shockley

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1366273898

Courtney Leigh Shockley is a Nurse Practitioner in Draper, Utah. Qualified in 2024, 2 years ago. Practices with Numinus Wellness UT Inc, a 51-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
2
Licensed in
UT
In the registry since
2024

Practice location Address checks out

721 E 12200 S
Draper, UT 84020-9723
Phone: (801) 368-8989
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 13654530-4405 (UT)

Record details

NPI number1366273898
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 7, 2024
Last updated in NPPESAugust 7, 2024
Certification dateAugust 7, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Numinus Wellness Ut Inc — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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