KELLIE KAISER BROCK NURSE PRACTITIONER
NPI 1104693761
Nurse Practitioner - Family in Niceville, FL

Q: What is Kellie Brock's NPI number?

The NPI number for Kellie Brock is 1104693761. It was assigned to this individual provider in the NPPES registry on December 5, 2023.

Q: What is Kellie Brock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kellie Brock was last updated on December 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 05, 2023

1571 LAKESIDE DR, NICEVILLE, FL 32578(713) 582-0937 Get Directions Write a Review

NPPES record last updated: December 5, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kellie Kaiser Brock Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLIE KAISER BROCK NURSE PRACTITIONER (NPI 1104693761) is an individual family provider in Niceville, Florida, licensed in Florida (11029005) and active in the NPI registry since December 2023.

NPPES Registry Identity

NPI1104693761

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKELLIE KAISER BROCKCredential: NURSE PRACTITIONER

Location Address1571 LAKESIDE DRNiceville, FL 32578-4161

Mailing Address1571 Lakeside DrNiceville, FL 32578-4161 · (171) 358-2093

Phone(713) 582-0937

Sole ProprietorYes

Enumeration DateDecember 5, 2023

NPPES CertifiedDecember 5, 2023

✔ NPI 1104693761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in FL · 11029005

1571 LAKESIDE DR, Niceville, FL 32578

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kellie Brock's NPI number?

The NPI number for Kellie Brock is 1104693761. It was assigned to this individual provider in the NPPES registry on December 5, 2023.

Where is Kellie Brock located?

Kellie Brock practices at 1571 Lakeside Dr, Niceville, FL 32578. The listed phone number is (713) 582-0937.

What is Kellie Brock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Kellie Brock was last updated on December 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.