Provider Demographics
NPI:1053601815
Name:SCHROCK, MELINDA MAY (NP)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:MAY
Last Name:SCHROCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 AIRPORT DR
Mailing Address - Street 2:C5
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-4726
Mailing Address - Country:US
Mailing Address - Phone:850-544-6396
Mailing Address - Fax:
Practice Address - Street 1:1311 AIRPORT DR
Practice Address - Street 2:C5
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-4726
Practice Address - Country:US
Practice Address - Phone:850-544-6396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4011863363L00000X
FLARNP9286651363LF0000X
FLAPRN9286651363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily