Provider Demographics
NPI:1710406947
Name:CAPETOLA, BROOKE (CRNP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:CAPETOLA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 ARCOLA RD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3954
Mailing Address - Country:US
Mailing Address - Phone:484-565-8440
Mailing Address - Fax:
Practice Address - Street 1:599 ARCOLA RD STE 200
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3954
Practice Address - Country:US
Practice Address - Phone:484-565-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN634952207Q00000X
PASP018032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine