Individual
DR. BONNIE JEAN NOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4525 SOUTH BLVD STE 200, VIRGINIA BEACH, VA 23452-1147
(757) 227-3820
(757) 226-9021
Mailing address
4525 SOUTH BLVD STE 200, VIRGINIA BEACH, VA 23452-1147
(757) 227-3820
(757) 226-9021
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0102049966
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006800581
—
VA
01
—
19409
BLUE CROSS BLUE SHIELD
VA
01
—
2300068
UNITED HEALTH CARE
—
01
—
462069061
TRICARE
—
05
—
906168
—
NC
Enumeration date
06/30/2006
Last updated
02/17/2022
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