Individual
MARIYA NIKOLAEVNA BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-7001
(859) 257-1000
(859) 218-7658
Mailing address
364 AFTON LN, LONDON, KY 40741-7828
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4027616
KY
Other
Enumeration date
10/07/2024
Last updated
12/18/2024
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