Individual provider · NPI-1

Amanda Dee Brock, APRN

Nurse Practitioner, Family · Somerset, KY

NPI number1013165786

StatusActive

Last updated in NPPESMay 12, 2023

Details

NPI: 1013165786
Entity type: Individual (NPI-1)
Name: Amanda Dee Brock
Credential: APRN
Sex: Female
Sole proprietor: No
Enumeration date: Sep 5, 2008
Certification date: May 12, 2023
Last updated: May 12, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	3005621	KY	Yes
163WG0000X	Registered Nurse, General Practice	5621P	KY

Practice location

350 Langdon St
Somerset, KY 42503-2786

Phone 606-678-8155 · Fax 606-678-7548

Mailing address

Po Box 1080
Burkesville, KY 42717-1080

Phone 270-858-6655 · Fax 270-858-4607

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