Provider Demographics
NPI:1265573034
Name:BATZEL, BROOK H (MSN, CRNP)
Entity type:Individual
Prefix:
First Name:BROOK
Middle Name:H
Last Name:BATZEL
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:BROOK
Other - Middle Name:H
Other - Last Name:BATZEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, CRNP
Mailing Address - Street 1:8 MORTON AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-2210
Mailing Address - Country:US
Mailing Address - Phone:610-595-0494
Mailing Address - Fax:
Practice Address - Street 1:8 MORTON AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-2210
Practice Address - Country:US
Practice Address - Phone:610-595-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005469X363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S78013Medicare UPIN