Healthcare Provider Details

I. General information

NPI: 1982522231
Provider Name (Legal Business Name): BROOKE BARLOW PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 HEATHCOTE VILLAGE WAY UNIT 270
GAINESVILLE VA
20155-3196
US

IV. Provider business mailing address

7051 HEATHCOTE VILLAGE WAY UNIT 270
GAINESVILLE VA
20155-3196
US

V. Phone/Fax

Practice location:
  • Phone: 571-636-9601
  • Fax:
Mailing address:
  • Phone: 571-636-9601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110012121
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: