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Individual

MARCIA LYNNE SHROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
122 N WATTERSON TRL, LOUISVILLE, KY 40243-2700
(502) 314-7050
(502) 245-7992
Mailing address
122 N WATTERSON TRL, LOUISVILLE, KY 40243-2700
(502) 314-7050
(502) 245-7992

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
02529
NM
363LA2200X
Adult Health Nurse Practitioner
124312
TX
363LA2200X
Adult Health Nurse Practitioner
18795
SC
363LA2200X
Adult Health Nurse Practitioner
201505322NP-PP
OR
363LA2200X
Adult Health Nurse Practitioner
Primary
3004426
KY
363LA2200X
Adult Health Nurse Practitioner
5009232
NC
363LA2200X
Adult Health Nurse Practitioner
99063696A
IN
363LA2200X
Adult Health Nurse Practitioner
CNP151106
ME
363LP2300X
Primary Care Nurse Practitioner
COA.14296-NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18795
STATE ARNP LICENSE
SC
01
201504071RN
OR RN LICENSE
OR
01
201505322NP-PP
OR NP LICENSE
OR
01
3004426
STATE APRN LICENSE
KY
01
5009232
NC NP LICENSE
NC
05
7100214550
KY
01
71005296A
IN NP LICENSE
IN
01
AP124312
STATE ARNP LICENSE
TX
01
CNP-02529
STATE ARNP LICENSE
NM
01
CNP151106
NP LICENSE
ME
01
COA.14296-NP
STATE NP LICENSE
OH
Enumeration date
03/28/2007
Last updated
07/26/2021
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