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Individual

SHAYNA DEVORAH ROCKOVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
13230 MANCHESTER RD, DES PERES, MO 63131-1706
(314) 821-2886
Mailing address
5132 N ELSTON AVE, CHICAGO, IL 60630-2429
(847) 235-6130
(847) 941-0577

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017035520
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
NA
Enumeration date
10/30/2017
Last updated
02/27/2020
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