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General NPI Number Information
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NPI Number | 1255075339
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Entity Type | Organization
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Legal Business Name | LOVE AND HUMBLE MEDICAL CARE
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Dates
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Enumeration Date | 04/25/2022
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 9844 LORI RD STE 102
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City | CHESTERFIELD
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State | VA
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Zip | 23832-6691
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Country | US
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Telephone | 203-507-5653
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Fax |
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Provider Business Mailing Address
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Address Line | 9844 LORI RD STE 102
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City | CHESTERFIELD
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State | VA
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Zip | 23832-6691
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Country | US
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Telephone | 203-507-5653
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | GERLENE SHERARD
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Credential | FNP-C, PMHNP-BC
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Telephone | 203-507-5653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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