MEDICARE: CHRISTINE DAWN ALLEN BROCK FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5022006	NC

General Provider Information

NPI Number	:	1811788219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE DAWN ALLEN BROCK FNP-C

Provider Business Mailing Address
First Line	:	1023 BOYD LAKE RD
Second Line	:
City	:	HAMLET
State	:	NC
Zip	:	28345-8147
Country	:	US
Telephone Number	:	910-719-1601
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 DOCTORS DR
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-5057
Country	:	US
Telephone Number	:	919-292-2219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2025
Last Update Date	:	12/03/2025

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