Brock, Jessica Nicole

Brock, Jessica Nicole is an individual health care provider with primary practice located at 5955 Airport Blvd , Mobile AL 36608. 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 / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Brock, Jessica Nicole can be contacted via phone (251) 633-0573.

Contact Information

Primary practice address
5955 Airport Blvd Mobile AL 36608
Phone: (251) 633-0573
Fax: (251) 633-7367
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1-106242 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 1-106242 Alabama

Profile Details

NPI number 1053540450
LBN Legal business name Brock, Jessica Nicole
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2009
Last updated Feb 23rd, 2024 - about 2 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 1053540450 NPPES
Alabama Other 102I502393 MEDICARE
Alabama Other 3092229 MEDICARE
Alabama Other 512-05477 MEDICARE
Alabama MEDICAID 134189 MEDICARE
Alabama MEDICAID 222576 MEDICARE
Alabama Other 9582378 MEDICARE
Alabama Other P00927530 MEDICARE
Alabama Other Z12803 MEDICARE
Alabama Other 02482035 MEDICARE
Alabama Other 510-49658 MEDICARE
Alabama MEDICAID 214094 MEDICARE
Alabama Other 512-05479 MEDICARE

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