Individual provider · Type 1 NPI
La Wanna Wallen Brock, F.N.P., A.P.N.
Family Nurse Practitioner · Tazewell, TN
NPI number
1407932387
Active
Practice location
1442 North Broad Street, Suite 7
Tazewell, TN 37879
Fax (423) 526-2804
Mailing address
1037 Old Jacksboro Rd
Cumberland Gap, TN 37724-4444
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | APN6601 (TN) |
Family Nurse Practitioner: Definition to come...
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About NPI 1407932387
La Wanna Wallen Brock, F.N.P., A.P.N.'s National Provider Identifier is 1407932387, issued on Oct 31, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Tazewell, TN. The record was last updated on Jul 8, 2007.