LA WANNA WALLEN BROCK (NPI# 1407932387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407932387 |
| Entity Type | Individual |
| Full Name | LA WANNA WALLEN BROCK |
| Credential | F.N.P., A.P.N. |
| Practice Address |
1442 North Broad Street Suite 7 Tazewell TN 37879 |
| Mailing Address |
1037 Old Jacksboro Rd Cumberland Gap TN 37724-4444 |
| Practice Telephone | 4236266145 |
| Practice Fax Number | 4235262804 |
| Mailing Telephone | 4236266145 |
| Mailing Fax Number | 4235262804 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN6601 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1442 NORTH BROAD STREET SUITE 7 |
| City | TAZEWELL |
| State | TN |
| Zip Code | 37879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689174211 | Heather Hunley | Nurse Practitioner | 951 N. Broad St, Tazewell Express Care, Tazewell, TN 37879 | 2018-02-20 |
| 1225540495 | Amy Howe | Nurse Practitioner | 1582 N Broad St Ste 2, Tazewell, TN 37879 | 2017-10-28 |
| 1497063903 | Minton Family Dental Care | Dentist | 210 Cedar Fork Rd., Tazewell, TN 37879 | 2010-09-17 |
| 1528259470 | Foster Chiropractic, P.C. | Chiropractor | 2255 Hwy 25e, Suite 2, Tazwell, TN 37879 | 2007-08-06 |
| 1811075088 | Rondal Keith Brock | Physician Assistant | Tazewell Medical Clinic 1442 North Broad Street, Suite 7, Tazewell, TN 37879 | 2006-11-02 |
| 1922185644 | Tri State Sports Medicine and Rehabilitation Inc | Physical Therapist | 2255 Highway 25e Ste 4, Tazewell, TN 37879 | 2006-11-01 |
| 1952493462 | Home Town Pharmacy Inc. | Pharmacy | 1410 N. Broadstreet, Tazewell, TN 37879 | 2006-09-29 |
| 1700892429 | Trail of The Cumberlands Anesthesia Associates | Nurse Anesthetist, Certified Registered | 1850 Old Knoxville Hwy, Claiborne County Hospital, Tazewell, TN 37879 | 2006-08-01 |
| 1598718587 | Rosemary Kay Hall | Chiropractor | 1450 Broad St, Suite 1, Tazewell, TN 37879 | 2006-05-18 |
| 1780652735 | Nancy Jean Day | Nurse Practitioner | 620 Davis Drive, Tazewell, TN 37879 | 2006-03-08 |
| Find all providers in zip 37879 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699313528 | Ashley Smallwood | Nurse Practitioner | 1610 Tazewell Rd Ste 203, Tazewell, TN 37879-3648 | 2019-12-10 |
| 1689174211 | Heather Hunley | Nurse Practitioner | 951 N. Broad St, Tazewell Express Care, Tazewell, TN 37879 | 2018-02-20 |
| 1225540495 | Amy Howe | Nurse Practitioner | 1582 N Broad St Ste 2, Tazewell, TN 37879 | 2017-10-28 |
| 1780103564 | Bonita Marie Lawson | Nurse Practitioner | 351 Carter Ln, Tazewell, TN 37879-5087 | 2017-09-13 |
| 1134543911 | Karen Elizabeth Hart | Nurse Practitioner | 1632 Fincastle Tpke, Tazewell, VA 24651-6169 | 2014-02-13 |
| 1568586964 | Michele R Arns | Nurse Practitioner | 2255 Highway 25e, Suite 2, Tazewell, TN 37879-3857 | 2007-03-19 |
| 1952382426 | Ladonna Lee Osborne | Nurse Practitioner | 388 Ben Bolt Ave, Tazewell, VA 24651-5386 | 2005-11-10 |
| 1922619006 | Erika Benson | Nurse Practitioner | 951 N Broad St, Tazewell, TN 37879-4323 | 2020-08-12 |
| 1255985396 | Jessica R Warren | Nurse Practitioner | 951 N Broad St, Tazewell, TN 37879-4323 | 2019-07-26 |
| 1508334129 | Ado Inc. | Nurse Practitioner | 951 N Broad St, Tazewell, TN 37879-4323 | 2018-11-13 |
| Find all providers in TAZEWELL | ||||
Please comment or provide details below to improve the information on LA WANNA WALLEN BROCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.