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Individual

JESSICA ANN SHROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP--C

Contact information

Practice address
110 10TH ST SE, BANDON, OR 97411-9157
(541) 347-5191
(541) 266-4578
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
(541) 266-4578

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10035565
OR
363LF0000X
Family Nurse Practitioner
21334
TN

Other

Enumeration date
06/24/2016
Last updated
05/09/2025
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