=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366362782
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEEKEISHA STOVER NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2026
-----------------------------------------------------
Last Update Date | 07/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9460 AMBERDALE DR STE D
-----------------------------------------------------
City | NORTH CHESTERFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23236-1259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-728-2278
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 321 LIBERTY HALL DR
-----------------------------------------------------
City | FREDERICKSBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22406-5123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-426-9451
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 0024197021
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------