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1487806808
SHANE BROCK
LAS CRUCES, NM
NPI
1487806808
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: NM CNP01132/R46618)
Enumeration Date
2008-10-16
Last Update Date
2015-08-07
Business Address
Mr. SHANE BROCK CNP
1635 S DON ROSER DR LAS CRUCES VA CBOC
LAS CRUCES, NM 88011-4550
Phone number: 575-522-1241
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Mailing Address
Mr. SHANE BROCK CNP
1635 S DON ROSER DR LAS CRUCES VA CBOC
LAS CRUCES, NM 88011-4550
Phone number: 575-522-1241
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