Brock, La Wanna Wallen

Brock, La Wanna Wallen is an individual health care provider with primary practice located at 1442 North Broad Street Suite 7, Tazewell TN 37879. 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, La Wanna Wallen can be contacted via phone (423) 626-6145.

Contact Information

Primary practice address
1442 North Broad Street Suite 7 Tazewell TN 37879
Phone: (423) 626-6145
Fax: (423) 526-2804
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN6601 Tennessee

Profile Details

NPI number 1407932387
LBN Legal business name Brock, La Wanna Wallen
Credentials F.N.P., A.P.N.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2006
Last updated Jul 8th, 2007 - about 17 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.

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