Healthcare Provider Details

I. General information

NPI: 1336024512
Provider Name (Legal Business Name): JENNA KAY ROCK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HIGHWAY 89 NORTH
PRESCOTT AZ
86313-5001
US

IV. Provider business mailing address

500 HIGHWAY 89 NORTH
PRESCOTT AZ
86313-5001
US

V. Phone/Fax

Practice location:
  • Phone: 928-445-4860
  • Fax:
Mailing address:
  • Phone: 928-445-4860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1171375
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number1171375
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: