Healthcare Provider Details

I. General information

NPI: 1386007250
Provider Name (Legal Business Name): ILEANA ASANACHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 OLD FOREST RD STE A
LYNCHBURG VA
24501-6961
US

IV. Provider business mailing address

3700 OLD FOREST RD STE A
LYNCHBURG VA
24501-6961
US

V. Phone/Fax

Practice location:
  • Phone: 434-268-9130
  • Fax:
Mailing address:
  • Phone: 434-268-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024184418
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: