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General NPI Number Information
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NPI Number | 1386523595
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Entity Type | Individual
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Provider Name | COURTNEY BROOKE MITCHELL PHARM D
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Gender | Female
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 1123 PLAZA DR
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City | GRUNDY
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State | VA
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Zip | 24614-6780
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Country | US
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Telephone | 276-935-9406
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Fax |
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Provider Business Mailing Address
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Address Line | 5225 RIVERSIDE DR
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City | RAVEN
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State | VA
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Zip | 24639-8618
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Country | US
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Telephone | 276-701-9412
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202217923
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License Number State | VA
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