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General NPI Number Information
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NPI Number | 1699857748
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Entity Type | Individual
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Provider Name | ROBIN RAY SHOOK ANP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 520 COBB ST
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City | CADILLAC
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State | MI
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Zip | 49601-2588
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Country | US
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Telephone | 231-775-6521
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Fax | 231-775-1366
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Provider Business Mailing Address
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Address Line | 520 COBB ST
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City | CADILLAC
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State | MI
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Zip | 49601-2588
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Country | US
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Telephone | 231-775-6521
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Fax | 231-775-1366
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704184595
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71002233A
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License Number State | IN
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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 | 4704184595
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License Number State | MI
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