Healthcare Provider Details

I. General information

NPI: 1023936184
Provider Name (Legal Business Name): BROCK OCCUPATIONAL HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S TONOPAH DR STE 220
LAS VEGAS NV
89106-4042
US

IV. Provider business mailing address

600 S TONOPAH DR STE 220
LAS VEGAS NV
89106-4042
US

V. Phone/Fax

Practice location:
  • Phone: 702-427-0113
  • Fax: 833-468-5110
Mailing address:
  • Phone: 702-427-0113
  • Fax: 833-468-5110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANGELA DENISE BROCK
Title or Position: OWNER
Credential:
Phone: 702-427-0113