Provider Demographics
NPI:1033220322
Name:BROUSH, ERIN P (NNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:P
Last Name:BROUSH
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13340 ENCLAVE CREEK LN
Mailing Address - Street 2:APT. 201
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-5576
Mailing Address - Country:US
Mailing Address - Phone:919-720-8994
Mailing Address - Fax:
Practice Address - Street 1:1213 E CLAY ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5071
Practice Address - Country:US
Practice Address - Phone:804-828-9956
Practice Address - Fax:804-827-2323
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173279363LN0005X
NCBRO1-0438-3561363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal