Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Clint Brock

Individual provider Certified Registered Nurse Anesthetist · NPI 1275070369

Clint Brock is a Certified Registered Nurse Anesthetist (CRNA) in Mesa, Arizona. Qualified in 2017, 9 years ago. Practices with Banner - University Hospital Based Physicians LLC, a 347-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
9
Licensed in
AZ
In the registry since
2017
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Practice location Address checks out

1823 E Hackamore St
Mesa, AZ 85203-3908
Phone: (480) 620-0414
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 194103 (AZ)

Record details

NPI number1275070369
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 26, 2017
Last updated in NPPESJanuary 26, 2017
Mailing address1823 E Hackamore St, Mesa, AZ 85203-3908

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Banner - University Hospital Based Physicians Llc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Mesa