La Wanna Wallen Brock, F.N.P., A.P.N.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN6601 Issued in TN

Practice address

1442 North Broad Street
Suite 7
Tazewell, TN 37879

Phone

(423) 626-6145

Fax

(423) 526-2804

NPI assigned

Oct 31, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tazewell Medical Clinic, Inc.

  • Clinic/Center
  • Tazewell, TN
  • NPI 1417001645
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407932387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 OLD JACKSBORO RD",
            "city": "CUMBERLAND GAP",
            "state": "TN",
            "postal_code": "377244444",
            "telephone_number": "423-626-6145",
            "fax_number": "423-526-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 NORTH BROAD STREET",
            "address_2": "SUITE 7",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "37879",
            "telephone_number": "423-626-6145",
            "fax_number": "423-526-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "LA WANNA",
        "middle_name": "WALLEN",
        "credential": "F.N.P., A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN6601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Benson, FNP
• Marcie L Bledsoe, CRNA
• Julia Blocker, ARNP
• Makayla Brashears, PHARMD
• Matthew A Brayton, NP
• Rondal Keith Brock, P.A.C.
• Brown Family Practice, Inc. (Calvary Medical)
• Gary W. Brown Jr., NP-C
• Beth Ann Busby-Coon, PHARM. D.
• Priscilla Cameron, FNP-C

• Family Nurse Practitioner in Tazewell, TN
• Providers in Tazewell, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.