Devon Lauren Brosh
Individual provider Active NPI Athletic Trainer · Appomattox, VA
NPI 1174979280 · NPPES record last updated Sep 27, 2018
Key facts
- NPI
- 1174979280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 0126002728 (VA)
- Practice address
- 198 Evergreen Ave
Appomattox, VA 24522-4080 - Phone
- (434) 944-8928
- NPI assigned
- May 6, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0126002728 | VA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 0126002728 | VA | Yes |
Addresses
Primary practice location
198 Evergreen Ave
Appomattox, VA 24522-4080
Mailing address
1476 Silver Creek Dr
Lynchburg, VA 24503-5075
Phone (434) 944-8928
Other practice location 1
497 Fawn Rdg
Petersburg, WV 26847-8049
Phone (304) 668-2349
Other providers in Appomattox, VA
- Gregory Barton
- Blue Ridge Health Center Inc
- Tammy V Bogart
- Beulah Mae Bolden
- Teodora Brose
- Latiera Brown
- Kaitlyn Joy Marken Cardwell
- Central Virginia Family Physicians Inc
- Central Virginia Family Physicians, Inc
- Andrew J Chandler III
All providers in Appomattox, VA · Athletic Trainer in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.