Courtney Brooke Mitchell, PHARM D
Individual provider Active NPI Pharmacist · Grundy, VA
NPI 1386523595 · NPPES record last updated Sep 1, 2025
Key facts
- NPI
- 1386523595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202217923 (VA)
- Practice address
- 1123 Plaza Dr
Grundy, VA 24614-6780 - Phone
- (276) 935-9406
- NPI assigned
- Sep 1, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202217923 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202217923 | VA | Yes |
Addresses
Primary practice location
1123 Plaza Dr
Grundy, VA 24614-6780
Mailing address
5225 Riverside Dr
Raven, VA 24639-8618
Phone (276) 701-9412
Other providers in Grundy, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2025. 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.