IndividualActive
Amanda Brock, RN
NPI 1407423080 · Long-Term Care Clinical Nurse Specialist · Fort Wayne, IN
Provider details
- NPI number
- 1407423080
- Entity type
- Individual
- Primary specialty
- Long-Term Care Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- License
- 28193220A (IN)
Mailing address
6925 Lake Crest Ct
Fort Wayne, IN 46815-7975
Registry dates
- Enumerated
- 2021-06-10
- Last updated
- 2021-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.