Healthcare Provider Details

I. General information

NPI: 1538976360
Provider Name (Legal Business Name): BRITTANY NECHELLE MOORE CRNP-FAMILY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. BRITTANY NECHELLE BROKENBROUGH

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 EASTERN SHORE DR
SALISBURY MD
21804-6410
US

IV. Provider business mailing address

914 EASTERN SHORE DR
SALISBURY MD
21804-6410
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-1331
  • Fax:
Mailing address:
  • Phone: 410-546-1331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR251603
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: