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General NPI Number Information
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NPI Number | 1942967591
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Entity Type | Individual
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Provider Name | MARCIE E SCHOCK
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Gender | Female
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 4301 GREATHOUSE SPRINGS RD
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City | JOHNSON
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State | AR
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Zip | 72741
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Country | US
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Telephone | 479-674-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 611 SE JAMAICA DR
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City | BENTONVILLE
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State | AR
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Zip | 72712-3989
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Country | US
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Telephone | 214-598-0058
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Fax |
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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 | 212980
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License Number State | AR
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