Brock, Kymberli Raye

Brock, Kymberli Raye is an individual health care provider with primary practice located at 3841 Piper St Suite T100, Anchorage AK 99508-4624. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Brock, Kymberli Raye can be contacted via phone (907) 561-3211.

Contact Information

Primary practice address
3841 Piper St Suite T100 Anchorage AK 99508-4624
Phone: (907) 561-3211
Fax: (907) 562-7547
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X NP-586A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1073 Alaska

Profile Details

NPI number 1619972478
LBN Legal business name Brock, Kymberli Raye
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Oct 29th, 2013 - about 13 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 1619972478 NPPES
Other 000010147885 BLUE SHIELD
MEDICAID 1022256 BLUE SHIELD
MEDICAID 806735600 BLUE SHIELD

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