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Contact Information

SHANE BROCK, CNP
1635 S DON ROSER DR
LAS CRUCES VA CBOC
LAS CRUCES, NM88011-4550
 Phone: 575-522-1241
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SHANE BROCK · (Male)

NPI # 1487806808
Status Active
Credentials CNP (Certified Nurse Practitioner)
Entity Individual
Enumeration date 10/16/2008
Last updated 08/07/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • NM License # CNP01132/R46618
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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