Healthcare Provider Details

I. General information

NPI: 1104309186
Provider Name (Legal Business Name): LOUIS SAKWE AGPCNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2018
Last Update Date: 07/07/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MOB III 7702 E. PARHAM ROAD SUITE 318
HENRICO VA
23294-4374
US

IV. Provider business mailing address

PO BOX 31494
RICHMOND VA
23294-1494
US

V. Phone/Fax

Practice location:
  • Phone: 804-499-8811
  • Fax: 804-496-2026
Mailing address:
  • Phone: 804-282-9133
  • Fax: 804-282-9135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number0024176623
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: