Provider Demographics
NPI:1861270563
Name:RASNAKE, BREANNA MICHELLE (PNP-PC)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:MICHELLE
Last Name:RASNAKE
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:BREANNA
Other - Middle Name:MICHELLE
Other - Last Name:NAPIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26210 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-7504
Mailing Address - Country:US
Mailing Address - Phone:276-623-8100
Mailing Address - Fax:276-623-8126
Practice Address - Street 1:26210 LEE HWY
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7504
Practice Address - Country:US
Practice Address - Phone:276-623-8100
Practice Address - Fax:276-623-8126
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024188083363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics