Individual provider · NPI-1

Chasity Cowart Brock, NP-C

Nurse Practitioner, Family · Bremen, GA

NPI number1407291925
StatusActive
Last updated in NPPESSep 19, 2019

Details

NPI
1407291925
Entity type
Individual (NPI-1)
Name
Mrs. Chasity Cowart Brock
Credential
NP-C
Sex
Female
Sole proprietor
No
Enumeration date
May 10, 2013
Last updated
Sep 19, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyRN177270GAYes

Other names

  • Chasity Cowart (Former Name)

Practice location

222 Gordon St
Bremen, GA 30110-1519

Phone 770-537-1234 · Fax 770-537-1234

Mailing address

222 Gordon St
Bremen, GA 30110-1519

Phone 770-537-1234 · Fax 770-537-1237

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