Provider Demographics
NPI:1558824854
Name:BROSSMAN, NOELLE NICOLE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:NICOLE
Last Name:BROSSMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 ELM CREST DR
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5070
Mailing Address - Country:US
Mailing Address - Phone:412-995-8121
Mailing Address - Fax:
Practice Address - Street 1:620 NATIONAL RD STE 300
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6560
Practice Address - Country:US
Practice Address - Phone:304-233-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV102690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily