Individual
MARY JO BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 274-4779
(317) 948-9806
Mailing address
PO BOX 778912, CHICAGO, IL 60677-8912
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
28077995
IN
363LN0000X
Neonatal Nurse Practitioner
Primary
71001637
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200367730
—
IN
Enumeration date
11/17/2006
Last updated
09/03/2025
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