MISS SUSAN MICHELLE BROCK (NPI# 1730500430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730500430 |
Entity Type | Individual |
Full Name | MISS SUSAN MICHELLE BROCK |
Other Name | SUSAN MICHELLE SLAWSON |
Credential | NP |
Practice Address |
Lifeline Community Healthcare 6150 Oak Tree Blvd Ste 200 Independence OH 44131 |
Practice Telephone | 8008979177 |
Mailing Telephone | 8008979177 |
Enumeration Date | 2013-12-23 |
Last Update Date | 2020-10-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 3011567 | KY | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
22668 | TN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 201209630 | 05 | |
OH | 0099280 | 05 | |
IN | ANTHEM | 000000855421 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851893218 | Susan Brock | Social Worker | 296 Birnam Rd, Northfield, MA 01360-1151 | 2018-03-01 |
1366855132 | Susan Brock | Massage Therapist | 3260 Vineville Ave, Macon, GA 31204-2324 | 2014-06-09 |
Street Address |
LIFELINE COMMUNITY HEALTHCARE 6150 OAK TREE BLVD STE 200 |
City | INDEPENDENCE |
State | OH |
Zip Code | 44131 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902457161 | Emilie Hadley | Case Manager/Care Coordinator | 5700 Rockside Rd, Independence, OH 44131 | 2019-09-27 |
1316404015 | Denise Ann Shannon | Licensed Practical Nurse | 4700 Rocksde Road, Suite 100, Independence, OH 44131 | 2019-02-28 |
1255898433 | Elizabeth Spence | Specialist/Technologist | 806 Tuxedo Ave, Brooklyn Hts, OH 44131 | 2019-02-25 |
1407356819 | Stefani Smithburger | Social Worker | 6200 Rockside Woods Blvd, Suite 305, Independence, OH 44131 | 2018-02-13 |
1881107092 | Christine M Hernandez | Nurse Practitioner | 2150 Oak Tree Blvd Suite 200, Independence, OH 44131 | 2017-11-09 |
1639698368 | Jessica Ann Phillips-donnelly | Social Worker | 5001 Rockside Road, Crown Center II, Independence, OH 44131 | 2017-09-13 |
1437692274 | Susan Meghan Davis | Registered Nurse | 925 Keynote Circle Suite #300, Brooklyn Hts, OH 44131 | 2016-11-28 |
1629431507 | Patricia Lynn Berger | Counselor | 6200 Rockside Woods Blvd. Suite 305, Independence, OH 44131 | 2016-03-30 |
1265810428 | Sarah Krakowiak | Speech-Language Pathologist | 3330 Wynde Tree Drive, Seven Hills, OH 44131 | 2015-05-08 |
1255732525 | Michelle Rioux-nivens | Nurse Practitioner | 6150 Oak Tree Boulevard, Suite 200, Independence, OH 44131 | 2014-09-05 |
Find all providers in zip 44131 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316316698 | Benjamin Murbach | Nurse Practitioner | 14310 E 42nd St S, Independence, MO 64055-7308 | 2015-09-17 |
1417296336 | Sarah Turnbull | Nurse Practitioner | 19550 E 39th St S Ste 105, Independence, MO 64057-1926 | 2013-02-13 |
1417201260 | Theresa Marie Giersz | Nurse Practitioner | 4807 Rockside Road, Ste 110, Independence, OH 44131 | 2012-11-01 |
1104139781 | Katie Murray | Nurse Practitioner | 19550 East 39th St #210, Independence, MO 65047 | 2010-07-23 |
1619968070 | Johnna L Bodenstab | Nurse Practitioner | 17611 East 24 Highway, Suite 200, Independence, MO 64055-1823 | 2005-11-03 |
1336140318 | Mary Jane Maloney | Nurse Practitioner | 6100 Rockside Woods Blvd, Suite 425, Independence, OH 44131-2366 | 2005-08-02 |
1063413003 | Mary E Elchlinger | Nurse Practitioner | 6100 Rockside Woods Blvd N, Suite 425, Independence, OH 44131-2366 | 2005-08-01 |
1881234193 | Deidre Lynn Arch | Nurse Practitioner | 6801 Brecksville Rd Ste 10, Independence, OH 44131-5057 | 2020-01-14 |
1962967323 | Valerie Davis | Nurse Practitioner | 510 Peter Pan Rd, Independence, KS 67301-7301 | 2019-02-09 |
1407321169 | Alejandra De La Rosa | Nurse Practitioner | 6100 Rockside Woods Blvd N Ste 425, Independence, OH 44131-2340 | 2018-10-09 |
Find all providers in INDEPENDENCE |
City | INDEPENDENCE |
Zip Code | 44131 |
Please comment or provide details below to improve the information on MISS SUSAN MICHELLE BROCK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.