Natalie Brock, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

69978 Issued in ID

Practice address

1072 N Liberty St Ste 200
Boise, ID 83704-8963

Phone

(208) 302-4600

NPI assigned

Sep 24, 2021

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

• Natalie Roberts Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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

• Saint Alphonsus Specialty Services Inc

  • Trauma Surgery Physician
  • Boise, ID
  • NPI 1093040479

  Family

  NPD (past)

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633824000000",
    "number": "1649941071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 N LIBERTY ST STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048963",
            "telephone_number": "208-302-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 N LIBERTY ST STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048963",
            "telephone_number": "208-302-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "NATALIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-10-10",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "69978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "ROBERTS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Broadbent
• Broader Wellness, LLC
• Christopher Broadnax
• Broadway Chiropractic Center Professional Association
• Hanna Brock
• Seiji Brock, LCPC
• Debra Jean Brockert, LMSW
• Daniel J Broderick, DO
• Melva June Broderick, R.N.
• Thomas W Broderick, M.D.

• Family Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2021; 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.