Healthcare Provider Details

I. General information

NPI: 1386121531
Provider Name (Legal Business Name): DANIELLE PETROSKY FREE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 EDNAM CTR STE 201
CHARLOTTESVILLE VA
22903-4616
US

IV. Provider business mailing address

1010 EDNAM CTR STE 201
CHARLOTTESVILLE VA
22903-4624
US

V. Phone/Fax

Practice location:
  • Phone: 434-300-3733
  • Fax: 434-322-4082
Mailing address:
  • Phone: 434-300-3733
  • Fax: 434-322-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024176370
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: