Provider Demographics
NPI:1215491006
Name:BROCK, ALISHA ANN (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:ANN
Last Name:BROCK
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2073 DUTCH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-7020
Mailing Address - Country:US
Mailing Address - Phone:304-210-0061
Mailing Address - Fax:
Practice Address - Street 1:4421 EMERSON AVE STE 205
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1200
Practice Address - Country:US
Practice Address - Phone:304-693-6096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN92399-NP-C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily