| Patricia W Henderson Do Pc | |
|
1 Arh Lane Suite 800 Low Moor VA 24457 | |
| (540) 862-6750 | |
| (540) 862-3742 |
| Full Name | Patricia W Henderson Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Arh Lane, Low Moor, Virginia |
| Authorized Official Name and Position | Patricia W Henderson (OWNER) |
| Authorized Official Contact | 5408626750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patricia W Henderson Do Pc Po Box 629 Clifton Forge VA 24422-0629 Ph: (540) 862-6750 | Patricia W Henderson Do Pc 1 Arh Lane Suite 800 Low Moor VA 24457 Ph: (540) 862-6750 |
| NPI Number | 1508059429 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 06/02/2016 |
| Medicare PECOS PAC ID | 9537231345 |
|---|---|
| Medicare Enrollment ID | O20080710000207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508059429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0102037111 (Virginia) | Primary |
| 363AM0700X | Physician Assistant - Medical | 0110001381 (Virginia) | Secondary |
| Provider Name | Patricia W Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316942451 PECOS PAC ID: 3375631716 Enrollment ID: I20080710000246 |
| Provider Name | Ambra Nida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558517060 PECOS PAC ID: 4789750928 Enrollment ID: I20080911000524 |
| Provider Name | Robert Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356552376 PECOS PAC ID: 7416000856 Enrollment ID: I20090731000531 |
| Provider Name | Julie Quillin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548793623 PECOS PAC ID: 8527337062 Enrollment ID: I20170627001458 |
| Provider Name | Mary Kathleen Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659939387 PECOS PAC ID: 0941537591 Enrollment ID: I20190806001255 |
| Provider Name | Megan N Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144865932 PECOS PAC ID: 8022444686 Enrollment ID: I20200130002249 |
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