Healthcare Provider Details

I. General information

NPI: 1629012166
Provider Name (Legal Business Name): HILLARY BROOKE ROSENFELD CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 RADIO HILL RD
MARION VA
24354-6587
US

IV. Provider business mailing address

601 WASHINGTON AVE
NEWPORT KY
41071-1986
US

V. Phone/Fax

Practice location:
  • Phone: 276-782-1194
  • Fax:
Mailing address:
  • Phone: 859-291-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0001192901
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: