HEATHER ELLISON BROCK (NPI# 1992712442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992712442 |
| Entity Type | Individual |
| Full Name | HEATHER ELLISON BROCK |
| Credential | ANP |
| Practice Address |
3760 Piper St Ste 1108 Anchorage AK 99508-4683 |
| Mailing Address |
Po Box 4105 Portland OR 97208-4105 |
| Practice Telephone | 9072126900 |
| Practice Fax Number | 9072126936 |
| Mailing Telephone | 8669071068 |
| Mailing Fax Number | 4259179141 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2018-02-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 751 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
751 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1023124 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 851 E. Westpoint Dr, Ste 208, Wasilla, AK 996547183 | 9073735015 | 9073737015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891744827 | Heather Suzanne Brock | Physician Assistant | 100 Saint Clair Pkwy, Saint Simons Island, GA 31522-1007 | 2006-05-08 |
| 1215469200 | Heather Brock | Technician, Other | 1835 Gilmore Ave, Lakeland, FL 33805-3017 | 2017-03-30 |
| 1508230582 | Heather Brock | Nurse Practitioner | 909 Walnut St, Dept of Neurological Surgery, Phila, PA 19107-5211 | 2015-11-13 |
| 1730431818 | Heather Smith Brock | Nurse Anesthetist, Certified Registered | 2700 Wayne Memorial Dr, Goldsboro, NC 27534-9494 | 2012-10-12 |
| 1700939683 | Heather Brock | Nurse Practitioner | 8333 N Davis Hwy, Pensacola, FL 32514-6050 | 2007-01-22 |
| Street Address |
3760 PIPER ST STE 1108 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-4683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336764836 | Providence Health & Services - Washington | Psychologist | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2020-06-10 |
| 1235771593 | Crystal S Harris | Counselor | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2019-10-08 |
| 1477102705 | Susan Ratcliffe | Counselor | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2019-09-09 |
| 1376192070 | Theresa Rutchka | Counselor | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2019-09-05 |
| 1194373464 | Phyllis Rose | Counselor | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2019-08-29 |
| 1376061788 | Diana Belen Waddell | Social Worker | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2017-09-06 |
| 1699228247 | Christopher Isaac Cox | Counselor | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2016-08-01 |
| 1477934636 | Matthew Mark Huckabee | Psychiatry & Neurology | 3760 Piper St Ste 1108, Anchorage, AK 99508 | 2015-06-14 |
| 1467839183 | Nathaniel J Bell | Psychiatry & Neurology | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2015-05-01 |
| 1013255868 | Jasmine Porter | Counselor | 3760 Piper St Ste 1108, Anchorage, AK 99508 | 2013-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760040711 | Wanatsanan Somkanay | Nurse Practitioner | 2211 E Northern Lights Blvd Ste 101, Anchorage, AK 99508-4192 | 2019-06-04 |
| 1700395951 | Nicole Zonzel | Nurse Practitioner | 3831 Piper St Sll 020, Anchorage, AK 99508 | 2017-09-20 |
| 1164944229 | Rona Janel Johnson | Nurse Practitioner | 3900 Ambassador Dr Fl 4, Anchorage, AK 99508-5922 | 2017-07-11 |
| 1255762837 | Kimberly D Kubick Anp LLC | Nurse Practitioner | 4821 Haru Ln, Anchorage, AK 99517-3283 | 2013-12-06 |
| 1235483512 | Family Sleep Clinics, LLC | Nurse Practitioner | 9170 Jewel Lake Rd, Ste 104, Anchorage, AK 99502-5381 | 2012-11-07 |
| 1710103924 | Nancy Jayne Zellmer | Nurse Practitioner | 3340 Providence Dr Ste 358, Anchorage, AK 99508-4627 | 2007-04-17 |
| 1033254826 | Shoshanah R Stone | Nurse Practitioner | 3300 Providence Dr Ste 304, Anchorage, AK 99508-4621 | 2007-02-20 |
| 1831271345 | Richard C Ervin | Nurse Practitioner | 1300 E 4th Ave, Anchorage, AK 99501-2815 | 2006-10-20 |
| 1639267768 | Ronald Robert Haggett | Nurse Practitioner | 2925 Debarr Rd., Suite 300, Anchorage, AK 99508 | 2006-10-11 |
| 1407940760 | J. Dette Avalon | Nurse Practitioner | 3524 East 15th Ave, Anchorage, AK 99508 | 2006-10-03 |
| Find all providers in ANCHORAGE | ||||
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| 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.