Provider Demographics
NPI:1225287493
Name:BROCK, JANET LEIGH (ARNP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEIGH
Last Name:BROCK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:GRILLIOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JANET GRILLIOT, APRN
Mailing Address - Street 1:2100 N WALDRON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1176
Mailing Address - Country:US
Mailing Address - Phone:620-513-4820
Mailing Address - Fax:620-513-4821
Practice Address - Street 1:2100 N WALDRON ST STE 4
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1176
Practice Address - Country:US
Practice Address - Phone:620-513-4820
Practice Address - Fax:620-513-4821
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46279363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner