Healthcare Provider Details

I. General information

NPI: 1366362782
Provider Name (Legal Business Name): LEEKEISHA STOVER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9460 AMBERDALE DR STE D
NORTH CHESTERFIELD VA
23236-1259
US

IV. Provider business mailing address

321 LIBERTY HALL DR
FREDERICKSBURG VA
22406-5123
US

V. Phone/Fax

Practice location:
  • Phone: 804-728-2278
  • Fax:
Mailing address:
  • Phone: 540-426-9451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024197021
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: