JESSICA M BROCK (NPI# 1962636233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962636233 |
| Entity Type | Individual |
| Full Name | JESSICA M BROCK |
| Practice Address |
169 Highland Dr Mandeville LA 70471 |
| Practice Telephone | 5046212912 |
| Mailing Telephone | 5046212912 |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2009-05-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | 5969 | LA | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356909360 | Jessica Beth Brock | Early Intervention Provider Agency | 42 Gwendolyn Pl, East Islip, NY 11730-3220 | 2019-06-04 |
| 1902125024 | Jessica C Brock | Physician Assistant | Endocrinology Clinic, 740 S. Limestone, Lexington, KY 40536-0284 | 2010-05-28 |
| 1376157578 | Jessica Shae Brock | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-09-04 |
| 1851846802 | Jessica Suzanne Brock | Specialist/Technologist | 180 Hansen Ct, Wood Dale, IL 60191-1121 | 2016-08-19 |
| 1891191102 | Jessica Brock | Physical Therapist | 125 Dillmont Dr, Columbus, OH 43235-4658 | 2014-11-13 |
| 1295148914 | Jessica Marie Brock | Nurse Practitioner | 1010 Main St S, Mc Kee, KY 40447-7089 | 2014-06-10 |
| 1740582915 | Jessica Brock | Licensed Practical Nurse | 1680 Walden Ave, Cheektowaga, NY 14225-4914 | 2010-11-22 |
| 1053540450 | Jessica Nicole Brock | Nurse Practitioner | 5955 Airport Blvd, Mobile, AL 36608 | 2009-07-07 |
| 1699925537 | Jessica Gray Brock | Physician Assistant | 4207 Lake Boone Trl Ste 220, Raleigh, NC 27607-6685 | 2008-09-29 |
| Street Address |
169 HIGHLAND DR |
| City | MANDEVILLE |
| State | LA |
| Zip Code | 70471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497398234 | Joshua Joseph Leblanc | Pharmacist | 541 Asbury Dr., Mandeville, LA 70471 | 2019-10-24 |
| 1700356789 | John R. Macgregor Jr. M.d. (apmc) | Non-Pharmacy Dispensing Site | 1502 West Causeway Approach, Suite D, Mandeville, LA 70471 | 2018-12-03 |
| 1619462082 | Southern Family Chiropractic, LLC | Chiropractor | 2077 North Causeway Blvd, Mandeville, LA 70471 | 2018-06-27 |
| 1518459833 | Marissa Rose Ledet Corneille | Audiologist | 1420 N Causeway Blvd., Mandeville, LA 70471 | 2018-06-01 |
| 1891285193 | Tyler Gravley | Chiropractor | 2077 N Causeway Blvd, Suite 3, Mandeville, LA 70471 | 2018-05-14 |
| 1831640259 | Trey Stokes | Nurse Anesthetist, Certified Registered | 104 West Brighton Court, Mandeville, LA 70471 | 2016-10-20 |
| 1619420759 | Erin Salerno | Counselor | 6408 Village Ln, Mandeville, LA 70471 | 2016-07-25 |
| 1699121822 | Austin Fontenot | Chiropractor | 1011 N. Caueway Blvd. Ste 28, Mandeville, LA 70471 | 2016-05-06 |
| 1578935136 | Vanessa Hadden | Social Worker | 600 Mariners Plaza, Mandeville, LA 70471 | 2015-10-22 |
| 1134590912 | Slent Investments, LLC | Clinic/Center | 1420 North Causeway Boulevard, Suite B, Mandeville, LA 70471 | 2015-10-19 |
| Find all providers in zip 70471 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124567649 | Albert Le | Radiologic Technologist | 606 Carol Dr, Jefferson, LA 70121-1706 | 2017-02-16 |
| 1902355332 | Tammany Boutte | Radiologic Technologist | 16218 W La Hwy 700, Kaplan, LA 70548-6449 | 2016-09-27 |
| 1699191106 | Julie Perry Normand | Radiologic Technologist | 5915 Cherokee Ln, Alexandria, LA 71301-2708 | 2014-03-07 |
| 1568694610 | Michael Gerhold | Radiologic Technologist | 50 Magnolia Gardens Dr, Covington, LA 70435-9520 | 2009-08-21 |
| 1235381245 | Rachelle Logwood Washington | Radiologic Technologist | 2100 Mediamolle Dr, New Orleans, LA 70114-3436 | 2008-10-21 |
| 1346499936 | Michael Rene Rogers | Radiologic Technologist | 1031 W 25th Ave, Covington, LA 70433-1321 | 2008-09-18 |
| 1831353895 | Maryanne L Colburn | Radiologic Technologist | 721 Park Ridge Dr, River Ridge, LA 70123-1182 | 2008-07-17 |
| 1477712156 | Physicians Imaging-houma Associates, LLC | Radiologic Technologist | 132 Valhi Lagoon Xing, Houma, LA 70360-3208 | 2008-06-06 |
| 1184763617 | Patrick Lee Miller | Radiologic Technologist | 1021 Coolidge Street, Lafayette, LA 70503 | 2007-02-05 |
| 1659425544 | Gulf Coast Mobile Imaging | Radiologic Technologist | 174 Grant Road, Opelousas, LA 70570-0720 | 2007-01-22 |
| Find all providers with the same taxonomy | ||||
| City | MANDEVILLE |
| Zip Code | 70471 |
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| 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.