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General NPI Number Information
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NPI Number | 1164883260
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Entity Type | Organization
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Legal Business Name | VCUHS
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 1100 E LEIGH ST
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City | RICHMOND
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State | VA
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Zip | 23298-5070
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Country | US
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Telephone | 804-828-3414
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Fax |
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Provider Business Mailing Address
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Address Line | 7400 TURNER RD
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City | HENRICO
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State | VA
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Zip | 23231-6309
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Country | US
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Telephone | 804-512-6277
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. CARLEY G LOVELL
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Credential |
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Telephone | 804-512-6277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0024168156
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License Number State | VA
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