Most Relevant Information
Provider Data
| NPI Number: | 1003269192 |
| Provider Name: | MICHELE MARIE BROCK NURSE PRACTITIONER |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | M401206 |
Most Important Dates
| Enumeration Date: | 07/13/2016 |
| Last Updated: | 10/20/2021 |
Provider Practice Location
5380 S RAINBOW BLVD STE 120
LAS VEGAS
NV
891181878
Practice Location Phone/Fax
| Phone: | 7024634040 |
| Fax: |
Provider Mailing Location
10530 DISCOVERY DR
LAS VEGAS
NV
891353050
Provider Mailing Phone/Fax
| Phone: | 7028022841 |
| Fax: |