Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Krystal Rose Shock

Individual provider Family Nurse Practitioner · NPI 1255254819

Krystal Rose Shock is a Family Nurse Practitioner in Saint Clair Shores, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2026

Practice location Address checks out

22631 Greater Mack Ave Ste 100
Saint Clair Shores, MI 48080-2055
Phone: (586) 800-0086
Fax: (586) 800-0087
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704381967 (MI)

Record details

NPI number1255254819
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 31, 2026
Last updated in NPPESJuly 31, 2026
Certification dateJuly 31, 2026
Mailing addressPo Box 4236, Southfield, MI 48037-4236

Other providers in Saint Clair Shores