Individual
HEATHER BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
909 WALNUT ST, DEPT OF NEUROLOGICAL SURGERY, PHILA, PA 19107-5211
(610) 800-1261
Mailing address
61 CONCORD RD, ASTON, PA 19014-2902
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
SP015633
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
SP015633
PA
Other
Enumeration date
11/13/2015
Last updated
01/17/2018
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