Individual provider · Type 1 NPI

Shane Brock, CNP

Primary Care Nurse Practitioner · Las Cruces, NM

NPI number 1487806808 Active

Practice location

1635 S Don Roser Dr, Las Cruces Va Cboc
Las Cruces, NM 88011-4550

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300XCNP01132/R46618 (NM)

Primary Care Nurse Practitioner: Definition to come...

10 other providers at this address

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About NPI 1487806808

Shane Brock, CNP's National Provider Identifier is 1487806808, issued on Oct 16, 2008. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Las Cruces, NM. The record was last updated on Aug 7, 2015.