KELLIE KAISER BROCK NURSE PRACTITIONER NPI 1104693761

NPI Information

  • NPI: 1104693761
  • Provider Name: KELLIE KAISER BROCK, NURSE PRACTITIONER
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 1571 LAKESIDE DR
    NICEVILLE, FL
    ZIP 32578
  • Phone: (713) 582-0937

Map and Directions

Get Directions

NPI Details

Kellie Kaiser Brock, NURSE PRACTITIONER is a family nurse practitioner in Niceville, FL. Kellie Kaiser Brock, NURSE PRACTITIONER NPI is 1104693761. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1571 LAKESIDE DR
NICEVILLE, FL
ZIP 32578-161
Phone: (713) 582-0937

The enumeration date for this NPI number is 12/5/2023 and was last updated on 12/5/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily11029005FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.