Brock, Susan Michelle

Brock, Susan Michelle is an individual health care provider with primary practice located at Lifeline Community Healthcare 6150 Oak Tree Blvd Ste 200, Independence OH 44131. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Brock, Susan Michelle can be contacted via phone (800) 897-9177.

Contact Information

Primary practice address
Lifeline Community Healthcare 6150 Oak Tree Blvd Ste 200 Independence OH 44131
Phone: (800) 897-9177
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3011567 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 22668 Tennessee

Profile Details

NPI number 1730500430
LBN Legal business name Brock, Susan Michelle
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2013
Last updated Dec 16th, 2020 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1730500430 NPPES
Indiana Other 000000855421 ANTHEM
Indiana MEDICAID 201209630 ANTHEM
Indiana MEDICAID 0099280 ANTHEM

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