Provider Demographics
NPI:1285868133
Name:BOCK CRNP SERVICES
Entity Type:Organization
Organization Name:BOCK CRNP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BOCK
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:717-920-9579
Mailing Address - Street 1:20 DANNAH DR
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7924
Mailing Address - Country:US
Mailing Address - Phone:717-920-9579
Mailing Address - Fax:717-920-9531
Practice Address - Street 1:2801 N FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1269
Practice Address - Country:US
Practice Address - Phone:717-920-9579
Practice Address - Fax:717-920-9531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center