Healthcare Provider Details

I. General information

NPI: 1144090606
Provider Name (Legal Business Name): COMPASSIONATE CARE TELEHEALTH SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 PATCHWORK DR
STEPHENSON VA
22656-2067
US

IV. Provider business mailing address

237 PATCHWORK DR
STEPHENSON VA
22656-2067
US

V. Phone/Fax

Practice location:
  • Phone: 724-826-6748
  • Fax: 877-940-3601
Mailing address:
  • Phone: 724-826-6748
  • Fax: 877-940-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTHA ADAIR NOLEN VESTERLUND
Title or Position: OWNER, NURSE PRACTITIONER
Credential: DNP, APRN, FNP-C,
Phone: 434-941-2739