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General NPI Number Information
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NPI Number | 1548389752
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Entity Type | Individual
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Provider Name | MARCIA LYNNE SHROCK APRN
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 122 N WATTERSON TRL
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City | LOUISVILLE
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State | KY
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Zip | 40243-2700
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Country | US
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Telephone | 502-314-7050
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Fax | 502-245-7992
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Provider Business Mailing Address
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Address Line | 122 N WATTERSON TRL
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City | LOUISVILLE
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State | KY
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Zip | 40243-2700
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Country | US
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Telephone | 502-314-7050
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Fax | 502-245-7992
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5009232
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 201505322NP-PP
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | CNP151106
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 18795
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 99063696A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 124312
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 02529
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License Number State | NM
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Taxonomy #8
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | COA.14296-NP
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License Number State | OH
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Taxonomy #9
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 3004426
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License Number State | KY
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