Individual
HEATHER ELLISON BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3760 PIPER ST STE 1108, ANCHORAGE, AK 99508-4683
(907) 212-6900
(907) 212-6936
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
751
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
751
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023124
—
AK
Enumeration date
08/01/2006
Last updated
02/22/2024
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