Chanda Brock, LPN is a
Licensed Practical Nurse based in Swansea, Illinois. Chanda Brock is licensed to practice in Missouri (license number 2005009072) and her current practice location is
10 Edwards Dr Apt 5, Swansea, Illinois. She can be reached at her office (for appointments etc.) via phone at
(618) 570-1401.
NPI number for Chanda Brock is 1598050924 and her current mailing address is 10 Edwards Dr Apt 5, Swansea, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1598050924.
Provider's Profile
Full Name | Chanda Brock |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 10 Edwards Dr Apt 5, Swansea, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1598050924
- Provider Enumeration Date: 06/14/2011
- Last Update Date: 06/14/2011
Medical Identifiers
Medical identifiers for Chanda Brock such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1598050924 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 2005009072 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Chanda Brock is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Chanda Brock, LPN 10 Edwards Dr Apt 5, Swansea, IL 62226-8204 Ph: (618) 570-1401 | Chanda Brock, LPN 10 Edwards Dr Apt 5, Swansea, IL 62226-8204 Ph: (618) 570-1401 |
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