Individual
LANEY ELIZABETH BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2222 JACKSON AVE W, OXFORD, MS 38655-5409
(662) 380-5560
Mailing address
498 HILLCREST CIR, CLEVELAND, MS 38732-2008
(662) 719-8197
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906355
MS
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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