Individual
AMANDA LYNN BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1511 SURGEONS DR, TALLAHASSEE, FL 32308-4680
(850) 701-0695
Mailing address
1511 SURGEONS DR, TALLAHASSEE, FL 32308-4680
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
11022900
FL
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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