Individual
GINA MICHELLE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8 RICHLAND MEDICAL PARK DR STE 400, COLUMBIA, SC 29203-8004
(803) 765-0871
(803) 765-9215
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26424
SC
Other
Enumeration date
06/12/2023
Last updated
06/27/2023
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