Provider Demographics
NPI:1619277472
Name:SCHOCK, JULIE MARIE (MS, RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:SCHOCK
Suffix:
Gender:F
Credentials:MS, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:18001 E 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3803
Mailing Address - Country:US
Mailing Address - Phone:586-247-4300
Mailing Address - Fax:313-432-2935
Practice Address - Street 1:2603 ELECTRIC AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-6588
Practice Address - Country:US
Practice Address - Phone:810-987-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4074248393363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily