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General NPI Number Information
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NPI Number | 1386121531
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Entity Type | Individual
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Provider Name | DANIELLE PETROSKY FREE NP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2018
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1010 EDNAM CTR STE 201
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-4616
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Country | US
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Telephone | 434-300-3733
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Fax | 434-322-4082
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Provider Business Mailing Address
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Address Line | 1010 EDNAM CTR STE 201
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-4624
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Country | US
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Telephone | 434-300-3733
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Fax | 434-322-4082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024176370
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License Number State | VA
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