Brock, Amanda L
Brock, Amanda L is an sole proprietor health care provider with primary practice located at 110 Dublin Dr Ste A , Dover OH 44622-7805. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Brock, Amanda L can be contacted via phone (330) 364-8038.Contact Information
Primary practice address
110 Dublin Dr Ste A
Dover OH 44622-7805
Phone: (330) 364-8038
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 341552 | Ohio |
Profile Details
| NPI number | 1093143844 |
|---|---|
| LBN Legal business name | Brock, Amanda L |
| Credentials | MSN, APRN, FNP-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 14th, 2013 |
| Last updated | May 22nd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093143844 | NPPES |
| Ohio | MEDICAID | H2298500095054 |
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