Provider Demographics
NPI:1841381795
Name:BROCK, ELIZABETH KATZ (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KATZ
Last Name:BROCK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1201 SEVEN LOCKS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2931
Mailing Address - Country:US
Mailing Address - Phone:301-652-5771
Mailing Address - Fax:301-652-6332
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:RM 4B42
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-7259
Practice Address - Fax:202-877-7258
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCRN967858363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC037403600Medicaid
MD006164600Medicaid
VA010259304Medicaid
VA010259304Medicaid
DC018886W15Medicare PIN