MEDICARE: MRS. GAIL PACHARIS BROCK NP

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	363LA2200X	Adult Health Nurse Practitioner	185982	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245284884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GAIL PACHARIS BROCK NP

Provider Business Mailing Address
First Line	:	DUKE UNIVERSITY MEDICAL CTR
Second Line	:	7623B HOSPITAL NORTH BOX 3128
City	:	DURHAM
State	:	NC
Zip	:	27710-0001
Country	:	US
Telephone Number	:	919-681-3810
Fax Number	:	919-613-5137

Provider Business Practice Location Address
First Line	:	DUKE UNIVERSITY MEDICAL CTR
Second Line	:	7623B HOSPITAL NORTH BOX 3128
City	:	DURHAM
State	:	NC
Zip	:	27710-0001
Country	:	US
Telephone Number	:	919-681-3810
Fax Number	:	919-613-5137

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	06/08/2011

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