Healthcare Provider Details

I. General information

NPI: 1619277472
Provider Name (Legal Business Name): JULIE MARIE SCHOCK MS, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 ELECTRIC AVE SUITE 1
PORT HURON MI
48060-6588
US

IV. Provider business mailing address

18001 E 10 MILE RD
ROSEVILLE MI
48066-3803
US

V. Phone/Fax

Practice location:
  • Phone: 810-987-5252
  • Fax:
Mailing address:
  • Phone: 586-247-4300
  • Fax: 313-432-2935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4074248393
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: