Healthcare Provider Details

I. General information

NPI: 1750831731
Provider Name (Legal Business Name): BROOKE ELIZABETH ASHLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BROOKE ELIZABETH MORELL NP

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 08/03/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 E MARKET ST STE 64B
HARRISONBURG VA
22801-5197
US

IV. Provider business mailing address

PO BOX 1430
HARRISONBURG VA
22803-1430
US

V. Phone/Fax

Practice location:
  • Phone: 540-564-5666
  • Fax: 757-579-8594
Mailing address:
  • Phone: 540-564-5666
  • Fax: 757-579-8594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001190976
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024174372
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: