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Organization

BC MEDICAL LLC

Active
Other names
Convenient Care Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NADINE BROCK APRN (MEMBER/NP)
(606) 330-1717
Entity
Organization

Contact information

Practice address
1675 S MAIN ST, LONDON, KY 40741-2050
(606) 330-1717
(606) 330-0061
Mailing address
1675 S MAIN ST, LONDON, KY 40741-2050
(606) 330-1717
(606) 330-0061

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3005556
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100058050
KY
Enumeration date
03/02/2015
Last updated
03/02/2015
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