BROCK ALAN WOOTEN NPI 1659116408

NPI Information

  • NPI: 1659116408
  • Provider Name: BROCK ALAN WOOTEN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 65 MESSIMER DR
    NEWARK, OH
    ZIP 43055
  • Phone: (740) 522-8477

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NPI Details

Brock Alan Wooten is a psychiatric/mental health nurse practitioner in Newark, OH with 1 years of experience. Brock Alan Wooten NPI is 1659116408. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

65 MESSIMER DR
NEWARK, OH
ZIP 43055-874
Phone: (740) 522-8477

The NPI 1659116408 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/25/2024 and was last updated on 6/25/2024.

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
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN.CNP.0036699OHIOYes

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: 3/30/2025

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