Healthcare Provider Details

I. General information

NPI: 1003676727
Provider Name (Legal Business Name): LAUREN BROOKE CHOI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN BROOKE REEVES RN

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 08/18/2024
Certification Date: 08/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 BREMO RD
RICHMOND VA
23226-1907
US

IV. Provider business mailing address

4612 SINGING BIRD DR
MOSELEY VA
23120
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-2011
  • Fax:
Mailing address:
  • Phone: 804-720-7725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001298107
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: