| Cavery Health Clinic | |
|
14330 Gideon Dr Ste B Woodbridge VA 22192-4640 | |
| (571) 408-9139 | |
| (703) 910-7021 |
| Full Name | Cavery Health Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 14330 Gideon Dr Ste B, Woodbridge, Virginia |
| Authorized Official Name and Position | Christy Michelle Harshberger (OWNER) |
| Authorized Official Contact | 5714086800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cavery Health Clinic 14330 Gideon Dr Ste B Woodbridge VA 22192-4640 Ph: (571) 408-9139 | Cavery Health Clinic 14330 Gideon Dr Ste B Woodbridge VA 22192-4640 Ph: (571) 408-9139 |
| NPI Number | 1700441326 |
|---|---|
| Provider Enumeration Date | 05/08/2019 |
| Last Update Date | 09/30/2024 |
| Medicare PECOS PAC ID | 2668872201 |
|---|---|
| Medicare Enrollment ID | O20210618000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700441326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lisa Ann Provance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588645378 PECOS PAC ID: 9830158955 Enrollment ID: I20041005000882 |
| Provider Name | Rene L Ernest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013071018 PECOS PAC ID: 7719900257 Enrollment ID: I20060110000955 |
| Provider Name | Mariya Bourget |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477870541 PECOS PAC ID: 4880880145 Enrollment ID: I20110526000330 |
| Provider Name | Christy M Harshberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750665196 PECOS PAC ID: 2860665320 Enrollment ID: I20151110000665 |
| Provider Name | Meggie A Keogh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346693322 PECOS PAC ID: 2466828306 Enrollment ID: I20221018003629 |
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