Individual
LISA RENE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1400 JOHNSTON WILLIS DR, STE A, RICHMOND, VA 23235-4765
(804) 379-8088
(804) 794-6067
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001106374
VA
163WX0800X
Orthopedic Registered Nurse
0001106374
VA
Other
Enumeration date
09/12/2008
Last updated
01/31/2013
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