MEDICARE: KAY ANN ASHBROOK CFNP

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	363LF0000X	Family Nurse Practitioner	0017001436	VA

General Provider Information

NPI Number	:	1891759015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY ANN ASHBROOK CFNP

Provider Business Mailing Address
First Line	:	2605 MOSES GRANDY TRL
Second Line	:	SUTIE D
City	:	CHESAPEAKE
State	:	VA
Zip	:	23323-6712
Country	:	US
Telephone Number	:	757-485-3600
Fax Number	:	757-485-9458

Provider Business Practice Location Address
First Line	:	2605 MOSES GRANDY TRL
Second Line	:	SUTIE D
City	:	CHESAPEAKE
State	:	VA
Zip	:	23323-6712
Country	:	US
Telephone Number	:	757-485-3600
Fax Number	:	757-485-9458

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	08/12/2008

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