Individual
MISS LA-URSHALAR B BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, FNP-BC
Contact information
Practice address
1365 CLIFTON RD NE BLDG C, SUITE 2126, ATLANTA, GA 30322-1013
(404) 778-1900
Mailing address
1365 CLIFTON RD NE BLDG C, SUITE 2126, ATLANTA, GA 30322-1013
(404) 778-1900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN 167836
GA
367A00000X
Advanced Practice Midwife
RN167836
GA
Other
Enumeration date
10/09/2008
Last updated
10/08/2013
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