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Individual

MRS. WHITNEY BARRIER BROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
401 SOUTHCREST CIR STE 212, SOUTHAVEN, MS 38671-6721
(662) 245-5270
Mailing address
PO BOX 1089, HAMMOND, LA 70404-1089
(985) 892-7070
(985) 892-7017

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
157298
LA
163W00000X
Registered Nurse
886293
MS
363LF0000X
Family Nurse Practitioner
Primary
902201
MS
363LF0000X
Family Nurse Practitioner
AP09581
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002928727
MS
Enumeration date
08/28/2017
Last updated
11/08/2023
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