# EAE PSYCHIATRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497316442
- **Authorized official:** STEPHEN P BOERSMAN PMHNP (PSYCHIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (540) 699-2324

## Contact information

- **Practice address:** 1900 E PARHAM RD, HENRICO, VA 23228-2206
- **Practice address phone:** (540) 699-2324
- **Practice address fax:** (540) 699-6548
- **Mailing address:** 1900 E PARHAM RD, HENRICO, VA 23228-2206
- **Mailing address phone:** (540) 699-2324
- **Mailing address fax:** (540) 699-6548

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2019
- **Last updated:** 10/07/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1578981460 | — | VA |