Brock, Amanda Dee
Brock, Amanda Dee is an individual health care provider with primary practice located at 350 Langdon St , Somerset KY 42503-2786. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Nursing Service Providers / General Practice. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Brock, Amanda Dee can be contacted via phone (606) 678-8155.Contact Information
Primary practice address
350 Langdon St
Somerset KY 42503-2786
Phone: (606) 678-8155
Fax: (606) 678-7548
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 3005621 | Kentucky |
| Nursing Service Providers / General Practice | 163WG0000X | 5621P | Kentucky |
Profile Details
| NPI number | 1013165786 |
|---|---|
| LBN Legal business name | Brock, Amanda Dee |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 5th, 2008 |
| Last updated | May 12th, 2023 - about 3 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 | 1013165786 | NPPES |
| Kentucky | MEDICAID | 7100099690 | |
| Kentucky | Other | 11988299 |
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