Provider Demographics
NPI:1376566554
Name:PEACHEY, BRIONY JAINE (NP)
Entity Type:Individual
Prefix:
First Name:BRIONY
Middle Name:JAINE
Last Name:PEACHEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 IRON BAR LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3603
Mailing Address - Country:US
Mailing Address - Phone:703-753-6772
Mailing Address - Fax:888-972-4515
Practice Address - Street 1:7500 IRON BAR LN
Practice Address - Street 2:SUITE 120
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:703-753-6772
Practice Address - Fax:888-972-4515
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001161128363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010201667Medicaid
VA010201667Medicaid
Q50637Medicare UPIN