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Individual

MS. ANN J STROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1700 MEDICAL WAY, SNELLVILLE, GA 30078-2195
(770) 979-9996
Mailing address
PO BOX 3559, SUWANEE, GA 30024-0993
(770) 979-9996

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
84532
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
RN154095
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00126662
MS
05
100851390A
OK
05
104691875
MI
05
136523701
AR
05
1562432
LA
05
172580601
TX
05
200381360A
KS
05
200457710A
IN
05
2460555
OH
05
274911
OR
05
3496653
TN
05
422400000
ME
05
4303416
MT
05
794273
AZ
05
8051846
NC
05
8949531
VA
05
913914115
MO
05
GAN375
SC
Enumeration date
06/27/2005
Last updated
06/28/2011
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