Tessa L Brock, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

125685 Issued in KS

Practice address

5315 N Pebblecreek CT
Bel Aire, KS 67226-2284

Phone

(316) 882-2101

NPI assigned

Jan 14, 2025

Last updated

Jan 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tessa L Williams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1003627753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 N PEBBLECREEK CT",
            "city": "BEL AIRE",
            "state": "KS",
            "postal_code": "672262284",
            "telephone_number": "316-882-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 N PEBBLECREEK CT",
            "city": "BEL AIRE",
            "state": "KS",
            "postal_code": "672262284",
            "telephone_number": "316-882-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "TESSA",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "125685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TESSA",
            "last_name": "WILLIAMS",
            "middle_name": "L",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Bel Aire, KS
• Providers in Bel Aire, KS by specialty
• Registered Nurse in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.