Individual
LEANDRA SUE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4918 W 28TH ST, TULSA, OK 74107-3302
(918) 231-9416
Mailing address
4918 W 28TH ST, TULSA, OK 74107-3302
(918) 231-9416
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R0123537
OK
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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