Lisa A Brock

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

27081177A Issued in IN

Practice address

7509 Charlestown Pike
Charlestown, IN 47111-9623

Phone

(812) 256-4686

NPI assigned

Mar 17, 2025

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2025.

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1649070749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7509 CHARLESTOWN PIKE",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471119623",
            "telephone_number": "812-256-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7509 CHARLESTOWN PIKE",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471119623",
            "telephone_number": "812-256-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "LISA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27081177A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lene Benoit
• Monica Lynne Berry
• Ellie Blair
• Daniel Bodano
• Pamela Sue Brewer
• Tonya M Broughton, APRN, FNP-BC
• Joseph Kenneth Broussard, MATS
• Heather Marie Brown
• Julie Brown, LPN
• Michael W Brumit, O.D.

• All providers in Charlestown, IN
• Licensed Practical Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.