Healthcare Provider Details

I. General information

NPI: 1093637571
Provider Name (Legal Business Name): CHELSEY BROOKE EARL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9434 COEBURN MOUNTAIN RD
WISE VA
24293-5944
US

IV. Provider business mailing address

PO BOX 208
BIG STONE GAP VA
24219-0208
US

V. Phone/Fax

Practice location:
  • Phone: 276-328-2721
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024198388
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: