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NPI Code Detail

MEDICARE: STEPHANIE BALDWIN HERNDON A.C.N.P.

MEDICARE: STEPHANIE BALDWIN HERNDON A.C.N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner0024166223VA

General Provider Information

NPI Number : 1992797476
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE BALDWIN HERNDON A.C.N.P.
Provider Business Mailing Address
First Line : 2369 STAPLES MILL RD
Second Line : SUITE 200
City : RICHMOND
State : VA
Zip : 23230-2909
Country : US
Telephone Number : 804-285-8206
Fax Number : 804-497-5469
Provider Business Practice Location Address
First Line : 7611 FOREST AVE
Second Line : SUITE 410
City : RICHMOND
State : VA
Zip : 23229-4946
Country : US
Telephone Number : 804-285-2965
Fax Number : 804-288-6602
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 03/31/2014

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