Provider Demographics
NPI:1487179388
Name:SCHROCK, MICHAELYN (PPCNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHAELYN
Middle Name:
Last Name:SCHROCK
Suffix:
Gender:F
Credentials:PPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-3734
Mailing Address - Country:US
Mailing Address - Phone:301-533-7060
Mailing Address - Fax:301-533-7060
Practice Address - Street 1:607 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-3734
Practice Address - Country:US
Practice Address - Phone:301-533-7060
Practice Address - Fax:877-766-4406
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV81133363LP0200X
MDAC003878363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics