Provider Demographics
NPI:1255606190
Name:SHROTH, MICHAEL (DNP, ANP-BC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SHROTH
Suffix:
Gender:M
Credentials:DNP, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3614
Mailing Address - Country:US
Mailing Address - Phone:615-679-9087
Mailing Address - Fax:706-230-9135
Practice Address - Street 1:926 MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3614
Practice Address - Country:US
Practice Address - Phone:615-679-9087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-10
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM57615363LA2200X
COC-APN.0002028-C363LA2200X
OR202110735NP-PP363LA2200X
TX817264363LA2200X
GARN161177363LA2200X
AR217199363LA2200X
VA0024179434363LA2200X
WAAP61195306363LA2200X
TXAP121792363L00000X
NY310749363LA2200X
AZ253138363LA2200X
TN16572363LA2200X
MI4704378488363LA2200X
IAH162886363LA2200X
UT12542195-4405363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health