Provider Demographics
NPI:1720058340
Name:ROCK, PAULA J (WHCNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:ROCK
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18832 WYNNFIELD RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1067
Mailing Address - Country:US
Mailing Address - Phone:952-949-3804
Mailing Address - Fax:
Practice Address - Street 1:2530 HORIZON DR
Practice Address - Street 2:CLIFFVIEW PLAZA
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-3091
Practice Address - Country:US
Practice Address - Phone:952-890-0940
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0837118363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
107981OtherUCARE
20079OtherSIOUX VALLEY HEALTH PLAN
HP21102OtherHEALTH PARTNERS
MN5K146ROOtherBCBS MN
07-02538OtherMEDICA
1016948OtherPREFERRED ONE
1070424OtherAMERICA'S PPO (ARAZ)
20079OtherSIOUX VALLEY HEALTH PLAN