PROVIDENCE MEDICAL LLC

FREDERICKSBURG, VA
NPI1831056191
Entity TypeOrganization
Authorized ContactMATTHEW DAUGHERTY
CEO
347-571-1312
Organization Subpart ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
Enumeration Date2026-01-08
Last Update Date2026-01-14
Business Address
PROVIDENCE MEDICAL LLC
150 RIVERSIDE PKWY STE 115 PMB 5560
FREDERICKSBURG, VA 22406-1094
Phone number: 347-571-1312
Mailing Address
PROVIDENCE MEDICAL LLC
150 RIVERSIDE PKWY STE 115
FREDERICKSBURG, VA 22406-1094
Phone number: 347-571-1312