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

Mrs. Shelley L Velickoff, ANP

Individual provider Nurse Practitioner · NPI 1811246531

Mrs. Shelley L Velickoff, ANP is a Nurse Practitioner in West Lafayette, Indiana. Qualified in 2012, 14 years ago. Practices with Randall Dermatology, PC, a 10-clinician group and accepts Medicare assignment. Licensed in Indiana and Washington.

Years since qualifying
14
Licensed in
IN, WA
In the registry since
2012
Specialties on file
2

Practice location Address checks out

124 Sagamore Pkwy W
West Lafayette, IN 47906
Phone: (765) 463-6722
Fax: (765) 463-0905
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 71011005A (IN)
Nurse Practitioner Taxonomy 363L00000X · Licence AP60277759 (WA)

Record details

NPI number1811246531
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP
Sole proprietorNo
NPI enumeratedSeptember 10, 2012
Last updated in NPPESDecember 19, 2024
Certification dateDecember 19, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Randall Dermatology, Pc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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