Provider Demographics
NPI:1548431232
Name:ROCK, ELLA RENEE (NP)
Entity Type:Individual
Prefix:MS
First Name:ELLA
Middle Name:RENEE
Last Name:ROCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ELLA
Other - Middle Name:
Other - Last Name:ROCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:SC HOUSE CALLS INC.
Mailing Address - Street 2:111 DOCTORS CIR.
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:800-491-0909
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:SC HOUSE CALLS INC.
Practice Address - Street 2:111 DOCTORS CIR.
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:800-491-0909
Practice Address - Fax:843-875-8981
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3374363LF0000X
NC5003365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA83329223Medicare PIN