Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | BRO1-0438-3561 | NC |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 0024173279 | VA |
NPI | 1033220322 |
---|---|
Provider Name | Erin P Broush |
First Address | Midlothian, VA 23114-5576 |
Second Address | Richmond, VA 23298-5071 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 14/09/2016 |