IRENE ELSIE BROCK REGISTERED NURSE
NPI 1659968360
Registered Nurse - Hemodialysis in Lucedale, MS
Active since December 29, 2020
About Irene Elsie Brock Registered Nurse NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IRENE ELSIE BROCK REGISTERED NURSE (NPI 1659968360) is an individual hemodialysis provider in Lucedale, Mississippi, licensed in Mississippi (R850912) and active in the NPI registry since December 2020.
NPPES Registry Identity
NPI1659968360
Entity TypeIndividualFemale
Primary Taxonomy163WH0500X
Provider Legal NameIRENE ELSIE BROCKCredential: REGISTERED NURSE
Location Address137 BROCK RDLucedale, MS 39452-4665
Mailing Address137 Brock RdLucedale, MS 39452-4665 · (601) 508-3435
Phone(601) 508-3435
Sole ProprietorYes
Enumeration DateDecember 29, 2020
NPPES CertifiedDecember 29, 2020
✔ NPI 1659968360 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyRegistered Nurse · HemodialysisNursing Service Providers
Taxonomy Code163WH0500X
License✔ Licensed in MS · R850912
137 BROCK RD, Lucedale, MS 39452
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659968360, enumerated as an "individual" on December 29, 2020.
The provider is located at 137 BROCK RD LUCEDALE, MS 39452 and the phone number is (601) 508-3435.
Registered Nurse with taxonomy code 163WH0500X and a focus in Hemodialysis.
