ADVANCE PRACTICE GERIATRICS AND WOUND SPECIALIST, LLC (NPI# 1205484441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205484441 |
| Entity Type | Organization |
| Organization Name | ADVANCE PRACTICE GERIATRICS AND WOUND SPECIALIST, LLC |
| Practice Address |
514 N Main St Rural Retreat VA 24368-3123 |
| Mailing Address |
1048 Terrace Dr Marion VA 24354-4138 |
| Practice Telephone | 2767831827 |
| Mailing Telephone | 2767831827 |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2019-09-09 |
| Authorized Official Name | NANCY MARSHALL (OWNER) |
| Authorized Official Telephone | 2767831827 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
514 N MAIN ST |
| City | RURAL RETREAT |
| State | VA |
| Zip Code | 24368-3123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283618 | Miranda Paige Davidson | Occupational Therapy Assistant | 514 N Main St, Rural Retreat, VA 24368-3123 | 2020-04-09 |
| 1699082479 | Brandon Coy Bogle | Psychologist | 514 N Main St, Rural Retreat, VA 24368-3123 | 2010-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770914053 | Sondra Alicia Monahan | Occupational Therapy Assistant | 694 Ward Branch Road, Rural Retreat, VA 24368 | 2013-12-11 |
| 1134466055 | Jeanie Lea Gonzalez | Pharmacist | 7059 West Lee Hwy, Rural Retreat, VA 24368 | 2013-01-11 |
| 1275805863 | Family Preservation Services, Inc. | Community/Behavioral Health | 514 North Main Street, Rural Retreat, VA 24368 | 2012-01-30 |
| 1871633024 | Lee Anne Francis Lefler | Pharmacy Technician | 7059 West Lee Highway, Rural Retreat, VA 24368 | 2007-02-07 |
| 1457446262 | Stampers Health Enterprises Inc | Durable Medical Equipment & Medical Supplies | 544 North Main St, Rural Retreat, VA 24368 | 2006-10-04 |
| 1356445589 | Michael W. Spraker | Dentist | 7061 West Lee Hwy, Rural Retreat, VA 24368 | 2006-09-08 |
| 1407804420 | Holly Lynn Smith | Legal Medicine | 306 South Main St., Rural Retreat, VA 24368 | 2006-05-04 |
| 1750725024 | Blue Ridge Medical Management Corporation | Orthopaedic Surgery | 7021 West Lee Highway, Suite B, Rural Retreat, VA 24368 | 2013-04-17 |
| 1811269640 | Blue Ridge Medical Management Corporation | Nurse Practitioner | 7021 West Lee Highway, Suite B, Rural Retreat, VA 24368 | 2012-02-09 |
| 1447543996 | Blue Ridge Medical Management Corporation | Family Medicine | 7021 West Lee Highway, Suite C, Rural Retreat, VA 24368 | 2011-05-17 |
| Find all providers in zip 24368 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831706597 | Martha Luz Alejandro-bird | Nurse Practitioner | 120 Kings Way Ste &3300, Williamsburg, VA 23185-2505 | 2020-09-28 |
| 1285240648 | Stephanie Williams Hatch | Nurse Practitioner | 304 Homestead Rd, Franklin, VA 23851-1345 | 2020-09-21 |
| 1346852639 | Britteny Nicole Stone-joel | Nurse Practitioner | 614 Rolfe Street, Hampton, VA 23661 | 2020-08-19 |
| 1093324469 | Grace A Odallo | Nurse Practitioner | 3441 Raytee Dr, Chesapeake, VA 23323-1230 | 2020-07-30 |
| 1558989186 | Olivia Brooke Wright | Nurse Practitioner | 2451 Midtown Ave Apt 1317, Alexandria, VA 22303-1437 | 2020-07-09 |
| 1467070342 | Amanda K Whitley | Nurse Practitioner | 401 Gordon Ave, Bristol, VA 24201-4106 | 2020-07-08 |
| 1194341792 | Tina Fulcher | Nurse Practitioner | 13300 Burley Ridge Ln, Chester, VA 23831-7119 | 2020-06-19 |
| 1366067373 | Luke Balmer | Nurse Practitioner | 3402 Upper Tillman Way, Powhatan, VA 23139-4349 | 2020-06-15 |
| 1174158539 | Monica Kristine Thompson | Nurse Practitioner | 6340 Miller Dr, Alexandria, VA 22315-3512 | 2020-03-05 |
| 1326670100 | Kristyn Dolores Fox | Nurse Practitioner | 830 Kempsville Rd Ste 2b223, Norfolk, VA 23502-3920 | 2020-02-10 |
| Find all providers with the same taxonomy | ||||
| City | RURAL RETREAT |
| Zip Code | 24368 |
Please comment or provide details below to improve the information on ADVANCE PRACTICE GERIATRICS AND WOUND SPECIALIST, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.