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Individual

STACEY BROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3050 MACK RD STE 300, FAIRFIELD, OH 45014-5376
(513) 751-2273
(513) 751-1848
Mailing address
3984 ROSEWOOD DRIVE, AMELIA, OH 45102

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.0028636
OH

Other

Enumeration date
05/11/2022
Last updated
06/22/2023
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