MR. SHANE BROCK


Address: 1635 S Don Roser Dr, Las Cruces Va Cboc, Las Cruces, NM 88011-4550
Phone: 5755221241

MR. SHANE BROCK (NPI# 1487806808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487806808
Entity Type Individual
Full Name MR. SHANE BROCK
Credential CNP
Practice Address 1635 S Don Roser Dr
Las Cruces Va Cboc
Las Cruces
NM 88011-4550
Practice Telephone 5755221241
Mailing Telephone 5755221241
Enumeration Date 2008-10-16
Last Update Date 2015-08-07
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
CNP01132/R46618 NM Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1635 S DON ROSER DR
LAS CRUCES VA CBOC
City LAS CRUCES
State NM
Zip Code 88011-4550

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548441678 Rhonda Michelle Ross Clinical Neuropsychologist 1635 S Don Roser Dr, Las Cruces, NM 88011-4550 2007-11-16
1003207879 Manuel Torres Social Worker 1635 S Don Roser Dr, Las Cruces, NM 88011-4550 2015-02-13
1780937359 Selin K Jacob Nurse Practitioner 1635 S Don Roser Dr, Las Cruces, Las Cruces, NM 88011-4550 2012-10-19
1871895342 Lani Michelle Cooper Pharmacist 1635 S Don Roser Dr, Las Cruces, NM 88011-4550 2010-12-03
1467769463 Rift Valley Neuropsychology, LLC Psychologist 1635 S Don Roser Dr, Las Cruces, NM 88011-4550 2010-09-12
1073742177 Cynthia Huertamontoya Social Worker 1635 S Don Roser Dr, Las Cruces, NM 88011-4550 2009-07-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356954648 Asc of The Heart Institute Internal Medicine 1250 N Sonoma Ranch Blvd, Las Cruces, NM 88011 2020-08-26
1104449206 Kruti Gitesh Shah Student in an Organized Health Care Education/Training Program Mountain View Regional Medical Cente, Graduate Medical Education, 4351 E Lohman Ave Suite 300, Las Cruces, NM 88011 2020-05-22
1831719368 Borna Mansouri Student in an Organized Health Care Education/Training Program 4351 E. Lahman Ave, Suite 300, Moutnainview Regional Medical Center Graduta, Las Cruces, NM 88011 2020-04-24
1306474408 Madonna Petula Phillip Student in an Organized Health Care Education/Training Program 4351 E Lohmon Avenue Suite 300, Las Cruces, NM 88011 2020-04-01
1285267849 Back In Action Therapy of Las Cruces Occupational Therapist 4440 Sonoma Ranch Blvd, Suite F, Las Cruces, NM 88011 2020-02-21
1649818725 Kimberly Ann Smetzer Registered Nurse 4401 East Lohman, Building 5, Las Cruces, NM 88011 2019-12-19
1548806375 Melinda Michelle Fowler Social Worker 2605 Terrace Drive, Las Cruces, NM 88011 2019-11-27
1871134692 Rio Grande Hematology and Oncology, LLC Internal Medicine 4391 East Lohman Ave., Las Cruces, NM 88011 2019-10-02
1972083640 Lorianna R. Narvaez Counselor 1155 S. Telshor Suite 302-a, Las Cruces, NM 88011 2018-08-21
1215416524 Aday Orthodontics, PC Dentist 2701 Missouri Ave., Suite D, Las Cruces, NM 88011 2018-08-08
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1275013922 Kathleen A Stevens Nurse Practitioner 2800 Doral Ct, Las Cruces, NM 88011-8616 2018-08-21
1154829570 Sarah Patricia Summers-barrio Nurse Practitioner 2450 S Telshor Blvd, Las Cruces, NM 88011-5141 2018-01-31
1255855086 Gabrielle Nichole Allsup Nurse Practitioner 1998 N Motel Blvd, Las Cruces, NM 88007-4100 2017-08-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1942808126 Compassion Docs LLC Nurse Practitioner 8100 Wyoming Blvd Ne Ste M-4302, Albuquerque, NM 87113-1946 2020-10-11
1598398216 Melissa Rose Pino Nurse Practitioner 10855 Firenze Dr Nw, Albuquerque, NM 87114-5287 2020-02-20
1043857410 Elizabeth F Baca Nurse Practitioner 2502 Marble Ave, Albuquerque, NM 87131-0001 2019-12-04
1386108546 Patricia Shepard Nurse Practitioner 1410 N 8th St Ste B, Carlsbad, NM 88220-3217 2019-01-22
1376945261 Kenneth Smith II Nurse Practitioner 224 W D. L. Ingram Ave, Cannon Afb, NM 88103-5103 2014-09-23
1023255510 Valencia Family Medicine & Express Care Nurse Practitioner 311 S. Los Lentes, Los Lunas, NM 87031 2009-01-21
1356358477 Mary Louise Blankenship Nurse Practitioner 3200 La Orilla Rd Nw, Albuquerque, NM 87120-2742 2006-08-02
1861093825 Lesley Roller Nurse Practitioner 328 Main St Ne, Los Lunas, NM 87031-7454 2020-11-05
1003415753 Jessica Wood Nurse Practitioner 1400 Main St Nw, Los Lunas, NM 87031-4812 2020-10-23
1023620143 Chona Miller Nurse Practitioner 1500 Lomas Blvd Nw, Albuquerque, NM 87104-1200 2020-08-19
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Competitor

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City LAS CRUCES
Zip Code 88011

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Dataset Information

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.

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