Provider Demographics
NPI:1952994014
Name:ROCKER, JOANNA ROSE
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:ROSE
Last Name:ROCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20107 ELDERBERRY RD
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-4031
Mailing Address - Country:US
Mailing Address - Phone:417-291-0844
Mailing Address - Fax:
Practice Address - Street 1:20107 ELDERBERRY RD
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-4031
Practice Address - Country:US
Practice Address - Phone:417-291-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050007176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife