Brock, Jessica C

Brock, Jessica C is an sole proprietor health care provider with primary practice located at 4423 Bardstown Rd , Louisville KY 40218-3235. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Brock, Jessica C can be contacted via phone (502) 749-7909.

Contact Information

Primary practice address
4423 Bardstown Rd Louisville KY 40218-3235
Phone: (502) 749-7909
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1902125024
LBN Legal business name Brock, Jessica C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 28th, 2010
Last updated Nov 23rd, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902125024 NPPES
Kentucky Other 1089287 NCCPA

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