Provider Demographics
NPI:1417752940
Name:HOLCOMB, BROOKE AUSTIN (PMH-RN, BC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:AUSTIN
Last Name:HOLCOMB
Suffix:
Gender:
Credentials:PMH-RN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 BIRDNECK CIR STE 126
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-5516
Mailing Address - Country:US
Mailing Address - Phone:757-385-0511
Mailing Address - Fax:
Practice Address - Street 1:409 BIRDNECK CIR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-5516
Practice Address - Country:US
Practice Address - Phone:757-385-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001263108163WA0400X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)