Healthcare Provider Details

I. General information

NPI: 1457759250
Provider Name (Legal Business Name): PIONEER BIRTH AND FAMILY CARE CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2692 POPE RD
IVANHOE VA
24350-3614
US

IV. Provider business mailing address

2692 POPE RD
IVANHOE VA
24350-3614
US

V. Phone/Fax

Practice location:
  • Phone: 276-637-3040
  • Fax: 276-637-3041
Mailing address:
  • Phone: 276-637-3040
  • Fax: 276-637-3041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERRIE JEANIENE DOSS
Title or Position: PRESIDENT
Credential: DNP, WHNP, CNM
Phone: 276-620-6341