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General NPI Number Information
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NPI Number | 1487179388
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Entity Type | Individual
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Provider Name | MICHAELYN SCHROCK PPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 607 OAKLAND AVE
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City | OAKLAND
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State | MD
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Zip | 21550-3734
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Country | US
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Telephone | 301-533-7060
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Fax | 877-766-4406
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Provider Business Mailing Address
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Address Line | 607 OAKLAND AVE
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City | OAKLAND
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State | MD
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Zip | 21550-3734
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Country | US
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Telephone | 301-533-7060
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Fax | 301-533-7060
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 81133
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AC003878
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License Number State | MD
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