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Individual
MISS SUSAN MICHELLE BROCK
Active
Individual
MISS SUSAN MICHELLE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3011567
KY
363LA2200X
Adult Health Nurse Practitioner
Primary
22668
TN
363LA2200X
Adult Health Nurse Practitioner
95019712
CA
Other
Enumeration date
12/23/2013
Last updated
04/16/2026
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