Healthcare Provider Details

I. General information

NPI: 1043883143
Provider Name (Legal Business Name): PROVERBS MEDICAL AND HEALTH CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 RINGGOLD INDUSTRIAL PKWY
DANVILLE VA
24540-5548
US

IV. Provider business mailing address

1128 LOCKETT DR
DANVILLE VA
24541-4050
US

V. Phone/Fax

Practice location:
  • Phone: 571-314-6136
  • Fax: 920-706-3788
Mailing address:
  • Phone: 434-203-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VICKIE LOU BRANDON
Title or Position: FNP/APMHCNS
Credential: DNP
Phone: 571-314-6136