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Organization
EAE PSYCHIATRY LLC
Active
Organization
EAE PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN P BOERSMAN PMHNP (PSYCHIATRIC NURSE PRACTITIONER)
(540) 699-2324
Entity
Organization
Contact information
Practice address
1900 E PARHAM RD, HENRICO, VA 23228-2206
(540) 699-2324
(540) 699-6548
Mailing address
1900 E PARHAM RD, HENRICO, VA 23228-2206
(540) 699-2324
(540) 699-6548
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578981460
—
VA
Enumeration date
06/20/2019
Last updated
10/07/2019
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