Individual
CASEY LEIGH BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2200 ADA AVE, STE 203, CONWAY, AR 72034-4985
(501) 205-8389
(888) 480-2845
Mailing address
198 SALMON LN, RUSSELLVILLE, AR 72802-2282
(501) 205-8389
(888) 480-2842
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A03651
AR
Other
Enumeration date
03/14/2012
Last updated
10/09/2012
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