MEDICARE: MRS. LENEKA N ANDERSON CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0001284982	VA
2	367A00000X	Advanced Practice Midwife	0024186240	VA

General Provider Information

NPI Number	:	1124733159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LENEKA N ANDERSON CNM

Provider Business Mailing Address
First Line	:	7603 FOREST AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4942
Country	:	US
Telephone Number	:	804-523-3712
Fax Number	:

Provider Business Practice Location Address
First Line	:	7603 FOREST AVE STE 207
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4937
Country	:	US
Telephone Number	:	804-523-3712
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2023
Last Update Date	:	01/24/2023

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