Healthcare Provider Details

I. General information

NPI: 1235112970
Provider Name (Legal Business Name): SHENANDOAH WOMENS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 LUCY DR
HARRISONBURG VA
22801-8036
US

IV. Provider business mailing address

240 LUCY DR
HARRISONBURG VA
22801-8036
US

V. Phone/Fax

Practice location:
  • Phone: 540-438-1314
  • Fax: 540-438-0797
Mailing address:
  • Phone: 540-438-1314
  • Fax: 540-438-0797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: TRACEY BARB
Title or Position: PRACTICE MANAGER
Credential:
Phone: 540-438-1314