BROOKLYNN SMOCK (NPI# 1710594767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710594767 |
| Entity Type | Individual |
| Full Name | BROOKLYNN SMOCK |
| Credential | N.P. |
| Practice Address |
309 W Johnson Rd La Porte IN 46350-1982 |
| Mailing Address |
Po Box 781076 Detroit MI 48278-1076 |
| Practice Telephone | 2195756400 |
| Mailing Telephone | 3175284800 |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71010373A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
309 W JOHNSON RD |
| City | LA PORTE |
| State | IN |
| Zip Code | 46350-1982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
| 1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
| 1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
| 1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
| 1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
| 1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
| 1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
| 1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
| Find all providers in zip 46350 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518575182 | Joanne Lacoste | Nurse Practitioner | 931 Myrtle Creek Dr, La Porte, TX 77571-2767 | 2020-07-20 |
| 1922634542 | Raymond Joseph Keener | Nurse Practitioner | 711 W 250 S, La Porte, IN 46350-8108 | 2020-03-15 |
| 1174050603 | Agnes U Ololo | Nurse Practitioner | 3802 Stuart Dr, La Porte, TX 77571-3942 | 2017-05-15 |
| 1750823795 | Tiffany Bowen | Nurse Practitioner | 508 Legacy Plz W, La Porte, IN 46350-5254 | 2016-11-08 |
| 1407159155 | Jocelyn Leigh Stowell | Nurse Practitioner | 311 Boyd Blvd., La Porte, IN 46350-3965 | 2010-12-17 |
| 1891838629 | Susan K Grace | Nurse Practitioner | 400 Teegarden St, Suite B, La Porte, IN 46350-3175 | 2007-02-14 |
| 1083228399 | April Donald | Nurse Practitioner | 204 Legacy Plz W, La Porte, IN 46350-5285 | 2020-09-03 |
| 1033748736 | Tami Clinkenbeard | Nurse Practitioner | 401 Newporte Blvd, La Porte, IN 46350-4099 | 2020-04-04 |
| 1255963336 | Brittany L. Catizone | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350-3105 | 2020-02-06 |
| 1538704101 | Heidi Marie Bickel | Nurse Practitioner | 311 Boyd Blvd, La Porte, IN 46350-3965 | 2019-11-07 |
| Find all providers in LA PORTE | ||||
Please comment or provide details below to improve the information on BROOKLYNN SMOCK.
| 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.