Shea Brock
Individual provider Active NPI Family Nurse Practitioner · Hoschton, GA
NPI 1972907699 · NPPES record last updated Jun 22, 2020
Key facts
- NPI
- 1972907699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN277423 (GA)
- Practice address
- 5848 Highway 124 W
Hoschton, GA 30548-5900 - Phone
- (866) 389-2727
- NPI assigned
- Oct 9, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN277423 | GA | MD | Family Nurse Practitioner |
| 0112168 | SC | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0112168 | SC | |
| Family Nurse Practitioner | 363LF0000X | RN277423 | GA | Yes |
Addresses
Primary practice location
5848 Highway 124 W
Hoschton, GA 30548-5900
Mailing address
5848 Highway 124 W
Hoschton, GA 30548-5900
Phone (864) 594-1999
Other names
- Shea Solich
Other providers in Hoschton, GA
- Lydia Breer
- Lisa Kay Brennan
- Bridge Medix
- Amanda Brinkman
- Chelsey Brissey
- Lucas Brown
- Cara Leigh Brumit
- Matt James Burch
- Lindsay Williams Burckhalter
- Hunter Burkhart
All providers in Hoschton, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.