Provider Demographics
NPI:1376613240
Name:NOCK, GLORIA R (RN)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:R
Last Name:NOCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4749 OWL HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:POCOMOKE CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21851-2573
Mailing Address - Country:US
Mailing Address - Phone:410-632-0884
Mailing Address - Fax:
Practice Address - Street 1:400-A WALNUT STREET
Practice Address - Street 2:POCOMOKE HEALTH CENTER
Practice Address - City:POCOMOKE
Practice Address - State:MD
Practice Address - Zip Code:21851
Practice Address - Country:US
Practice Address - Phone:410-957-2005
Practice Address - Fax:410-957-2417
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR035336163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS013Medicare ID - Type Unspecified