Healthcare Provider Details

I. General information

NPI: 1316171309
Provider Name (Legal Business Name): HENRICO WOMEN'S HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 FOREST AVE SUITE 316
RICHMOND VA
23229-4938
US

IV. Provider business mailing address

7605 FOREST AVE SUITE 316
RICHMOND VA
23229-4938
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-0044
  • Fax: 804-287-4317
Mailing address:
  • Phone: 804-282-0044
  • Fax: 804-287-4317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number0101035382
License Number StateVA

VIII. Authorized Official

Name: MRS. CONNIE LYNNE LAWSON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 804-282-7171