# CENTERCARE FAMILY PRACTICE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PEDSPLUS PRIMARY CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497106504
- **Authorized official:** MICKELINA LAURORE FNP (MANAGER)
- **Authorized official phone:** (239) 691-5450

## Contact information

- **Practice address:** 1300 EMANCIPATION HWY, FREDERICKSBURG, VA 22401-4600
- **Practice address phone:** (540) 289-2273
- **Practice address fax:** (540) 699-0214
- **Mailing address:** 1010 W KENSINGTON CIR, FREDERICKSBURG, VA 22401-8003
- **Mailing address phone:** (239) 691-5450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | VA | Yes |

## Other

- **Enumeration date:** 06/29/2016
- **Last updated:** 12/30/2022