Individual
OLIVIA ANNE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1001 SAINT JOSEPH LN, LONDON, KY 40741-8345
(859) 268-1030
(859) 269-4120
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3014262
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3014262
KENTUCKY BOARD OF NURSING APRN LICENSE
KY
Enumeration date
01/28/2020
Last updated
03/27/2020
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