Individual
AMANDA S. BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1215 SIDNEY ST, SUITE 202, BATESVILLE, AR 72501-7203
(870) 262-2000
Mailing address
1215 SIDNEY ST, SUITE 202, BATESVILLE, AR 72501-7203
(870) 262-2000
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
A03334ANP
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A03334ANP
LICENSE
AR
Enumeration date
03/12/2010
Last updated
03/12/2010
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